FDA Adverse Event Injury Summary report: N

PRECISION? MONTAGE? MRI

MDR report key: 22886496 · Received August 25, 2025

Report

Report Number
3006630150-2025-06855
Event Type
Injury
Date Received
August 25, 2025
Date of Event
July 30, 2025
Report Date
August 25, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729905943
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, 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-MRI. UPN: M365SC2408560. MODEL: SC-2408-56. SERIAL: (B)(6). BATCH: (B)(6). UDI: (B)(4). PRODUCT FAMILY: SCS-LINEAR LEADS-MRI. UPN: M365SC2408560. MODEL: SC-2408-56. SERIAL:(B)(6). BATCH: (B)(6). UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS EXPERIENCING INADEQUATE RELIEF FROM THE SPINAL CORD STIMULATION (SCS). PATIENT UNDERWENT AN EXPLANT PROCEDURE. NO FURTHER INFORMATION HAS BEEN OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1341872 PRECISION? MONTAGE? MRI STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1200 374337 08714729905943

Patients

Seq Age Sex Outcome Treatment
1 61 YR Female Required Intervention