FDA Adverse Event Injury Summary report: N

VERCISE GENUS?

MDR report key: 23200315 · Received October 2, 2025

Report

Report Number
3006630150-2025-08235
Event Type
Injury
Date Received
October 2, 2025
Date of Event
August 28, 2025
Report Date
October 2, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
NHL
PMA / PMN Number
P150031
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: DBS-LINEAR LEADS. UPN: M365DB2203450. MODEL: DB-2203-45. SERIAL: (B)(6). BATCH: 5002460. UDI: (B)(4). PRODUCT FAMILY: DBS-LINEAR LEADS. UPN: M365DB2203450. MODEL: DB-2203-45. SERIAL: (B)(6). BATCH: 5003272. UDI: (B)(4). PRODUCT FAMILY: DBS-EXTENSION. UPN: M365DB3216550. MODEL: DB-3216-55. SERIAL: (B)(6). BATCH: 5001310 UDI: (B)(4). PRODUCT FAMILY: DBS-EXTENSION. UPN: M365DB3216550. MODEL: DB-3216-55. SERIAL: (B)(6). BATCH: 5001267 UDI: (B)(4). PRODUCT FAMILY: DBS-LEAD FIXATION. UPN: M365DB4600C0. MODEL: DB-4600-C. SERIAL: NA. BATCH: 35765310 UDI: (B)(4). PRODUCT FAMILY: DBS-LEAD FIXATION. UPN: M365DB4600C0. MODEL: DB-4600-C. SERIAL: NA. BATCH: 35410440. UDI: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE DEEP BRAIN STIMULATION (DBS) PATIENT EXPERIENCED DRAINAGE IN THE SCALP AND CHEST ON THE RIGHT SIDE WHEREIN THE SITES WERE RED AND PAINFUL. THE PATIENT UNDERWENT A REVISION PROCEDURE WHERE THE FULL SYSTEM WAS EXPLANTED DUE TO INFECTION. THE PATIENT WAS DOING WELL POSTOPERATIVELY. THE EXPLANTED DEVICES WERE RETAINED BY THE MEDICAL FACILITY AND WERE NOT RETURNED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
278481 VERCISE GENUS? STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR NHL BOSTON SCIENTIFIC NEUROMODULATION CORPORATION DB-1232 780251

Patients

Seq Age Sex Outcome Treatment
1 63 YR Male Required Intervention