FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA? 16

MDR report key: 22672182 · Received July 30, 2025

Report

Report Number
3006630150-2025-06003
Event Type
Injury
Date Received
July 30, 2025
Date of Event
May 19, 2025
Report Date
July 30, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985082
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NE, 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-LINEAR LEADS, UPN: M365SC2218500, MODEL: SC-2218-50, SERIAL: (B)(6), BATCH: 7132633, UDI#: (B)(4). PRODUCT FAMILY: SCS-LINEAR LEADS, UPN: M365SC2218500, MODEL: SC-2218-50, SERIAL: (B)(6), BATCH: 7132711, UDI#: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING WEAKNESS AND DIFFICULTY IN LIFTING THE LEGS WHEN THE STIMULATION WAS ON. THE PHYSICIAN BELIEVED THAT IT WAS NOT DEVICE RELATED. IT WAS ALSO NOTED THAT THE PATIENT HAD INADEQUATE PAIN RELIEF. THE PATIENT UNDERWENT A SPINAL CORD STIMULATOR (SCS) SYSTEM EXPLANT PROCEDURE AND WAS DOING WELL POSTOPERATIVELY. THE EXPLANTED DEVICE COMPONENTS WERE KEPT BY THE MEDICAL FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
514359 WAVEWRITER ALPHA? 16 STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1216 581536 08714729985082

Patients

Seq Age Sex Outcome Treatment
1 58 YR Male Required Intervention