FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA?

MDR report key: 22343656 · Received June 27, 2025

Report

Report Number
3006630150-2025-04900
Event Type
Injury
Date Received
June 27, 2025
Date of Event
June 3, 2025
Report Date
September 16, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985099
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENT INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-PADDLE LEADS UPN: M365SC8336500 MODEL: SC-8336-50 SERIAL: (B)(6). BATCH: 7090703 UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT INFORMED OF BEING ADMITTED FOLLOWING THE IMPLANT PROCEDURE DUE TO SEVERE STOMACHACHE AND CONSTIPATION. THE PATIENT WAS ADMINISTERED WITH LAXATIVES AND HAS SINCE BEEN DISCHARGED. IT WAS ALSO NOTED THAT THE PATIENT DEVELOPED PROGRESSIVE ITCHING AT THE BACK WHICH WAS NOT DEVICE RELATED AND WAS MOST LIKELY DUE TO THE MEDICATIONS GIVEN. UPON FOLLOW-UP, THE SYMPTOMS HAVE COMPLETELY RESOLVED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT INFORMED OF BEING ADMITTED FOLLOWING THE IMPLANT PROCEDURE DUE TO SEVERE STOMACHACHE AND CONSTIPATION. THE PATIENT WAS ADMINISTERED WITH LAXATIVES AND HAS SINCE BEEN DISCHARGED. IT WAS ALSO NOTED THAT THE PATIENT DEVELOPED PROGRESSIVE ITCHING AT THE BACK WHICH WAS NOT DEVICE RELATED AND WAS MOST LIKELY DUE TO THE MEDICATIONS GIVEN. UPON FOLLOW-UP, THE SYMPTOMS HAVE COMPLETELY RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1803418 WAVEWRITER ALPHA? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1232 764761 08714729985099

Patients

Seq Age Sex Outcome Treatment
1 70 YR Female Required Intervention| H