FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA?

MDR report key: 22288573 · Received June 18, 2025

Report

Report Number
3006630150-2025-04592
Event Type
Injury
Date Received
June 18, 2025
Date of Event
December 29, 2024
Report Date
June 18, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985099
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: EXACT DATE UNKNOWN, EVENT OCCURRED IN APPROXIMATELY FOUR MONTHS AGO FROM DATE MANUFACTURER WAS MADE AWARE. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS. UPN: M365SC2218500. MODEL: SC-2218-50. SERIAL: (B)(6). BATCH: 7111589. UDI: (B)(4). PRODUCT FAMILY: SCS-LINEAR LEADS. UPN: M365SC2218500. MODEL: SC-2218-50. SERIAL: (B)(6). BATCH: 7111888. UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT PATIENT HAD DIFFICULTY CHARGING THE IMPLANTABLE PULSE GENERATOR (IPG) AND WAS NOTED THAT PATIENT WAS NOT ABLE TO GET ENOUGH PAIN RELIEF. THE PATIENT UNDERWENT A SPINAL CORD STIMULATOR (SCS) EXPLANT PROCEDURE WHERE IN ALL DEVICES WERE REMOVED AND THE PATIENT WAS DOING WELL POST OPERATIVELY. THE EXPLANTED DEVICE WILL NOT BE RETURN AS IT WAS KEPT AT THE FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1684965 WAVEWRITER ALPHA? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1232 543405 08714729985099

Patients

Seq Age Sex Outcome Treatment
1 76 YR Female Required Intervention