FDA Adverse Event Injury Summary report: N

PRECISION? MONTAGE? MRI

MDR report key: 22527434 · Received July 16, 2025

Report

Report Number
3006630150-2025-05583
Event Type
Injury
Date Received
July 16, 2025
Date of Event
June 23, 2025
Report Date
July 16, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729905943
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
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-LINEAR LEADS, UPN: M365SC2218500, MODEL: SC-2218-50, SERIAL: (B)(6), BATCH: 7071528, UDI: (B)(4). PRODUCT FAMILY: SCS-LINEAR LEADS, UPN:M365SC2218500, MODEL: SC-2218-50, SERIAL: (B)(6), BATCH: 7071394, UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT AN EXPLANT PROCEDURE DUE TO AN UNKNOWN REASON. NO FURTHER INFORMATION COULD BE OBTAINED DESPITE GOOD FAITH EFFORTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
154309 PRECISION? MONTAGE? MRI STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1200 365543 08714729905943

Patients

Seq Age Sex Outcome Treatment
1 44 YR Female Required Intervention