FDA Adverse Event Injury Summary report: N

PRECISION?

MDR report key: 22689833 · Received August 1, 2025

Report

Report Number
3006630150-2025-06083
Event Type
Injury
Date Received
August 1, 2025
Date of Event
July 8, 2025
Report Date
August 1, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729767688
PMA / PMN Number
P030017
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, 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. D2B: LGW - QRB. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS UPN: M365SC2218500, MODEL: SC-2218-50, SERIAL: (B)(6), BATCH: A46918 / 232486, UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED A FREQUENT CHARGING OF THE IMPLANTABLE PULSE GENERATOR (IPG). THE PATIENT UNDERWENT AN IPG AND LEAD REPLACEMENT PROCEDURE. THE EXPLANTED PRODUCTS WILL NOT BE RETURNED PER HOSPITAL POLICY. NO FURTHER INFORMATION HAS BEEN OBTAINED DESPITE GOOD FAITH EFFORTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1135857 PRECISION? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1110-02 187366 08714729767688

Patients

Seq Age Sex Outcome Treatment
1 86 YR Female Required Intervention