FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA? PRIME

MDR report key: 22144919 · Received June 4, 2025

Report

Report Number
3006630150-2025-03940
Event Type
Injury
Date Received
June 4, 2025
Date of Event
May 10, 2025
Report Date
June 4, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985075
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-PADDLE LEADS UPN: M365SC8336500 MODEL: SC-8336-50 SERIAL: (B)(6). BATCH: 7080425 UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT A SPINAL CORD STIMULATION (SCS) EXPLANT PROCEDURE DUE TO INFECTION. NO FURTHER INFORMATION HAS BEEN OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
398437 WAVEWRITER ALPHA? PRIME STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1432 216989 08714729985075

Patients

Seq Age Sex Outcome Treatment
1 45 YR Female Required Intervention