FDA Adverse Event Injury Summary report: N

VERCISE GENUS?

MDR report key: 22919546 · Received August 28, 2025

Report

Report Number
3006630150-2025-06977
Event Type
Injury
Date Received
August 28, 2025
Date of Event
August 4, 2025
Report Date
September 22, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
MHY
PMA / PMN Number
P150031
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. D2B: ADDITIONAL PRO CODE SELECTION THAT APPLIES TO THE INDICATION OF THIS DEVICE - <NHL, PJS>.

Additional Manufacturer Narrative · 0

B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT. D2B: ADDITIONAL PRO CODE SELECTION THAT APPLIES TO THE INDICATION OF THIS DEVICE - <NHL, PJS>.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS DEEP BRAIN STIMULATION (DBS) DEVICE WAS EXPLANTED DUE TO AN UNKNOWN REASON. THE LOCATION OF THE DEVICE IS UNKNOWN. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS DEEP BRAIN STIMULATION (DBS) DEVICE WAS EXPLANTED DUE TO AN UNKNOWN REASON. THE LOCATION OF THE DEVICE IS UNKNOWN. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. ADDITIONAL INFORMATION WAS RECEIVED STATING THAT THIS DBS DEVICE WAS ELECTIVELY REPLACED. THE PATIENT UNDERWENT AN IMPLANTABLE PULSE GENERATOR (IPG) REVISION PROCEDURE WHEREIN THEIR IPG WAS EXPLANTED AND REPLACED. THE IPG WAS RETAINED BY THE HOSPITAL AND WILL NOT BE RETURNED FOR ANALYSIS. POSTOPERATIVELY, THE PATIENT WAS STABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2221422 VERCISE GENUS? STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR MHY BOSTON SCIENTIFIC NEUROMODULATION CORPORATION DB-1416 210497

Patients

Seq Age Sex Outcome Treatment
1 73 YR Male Required Intervention