FDA Adverse Event Injury Summary report: N

WAVEWRITER ALPHA?

MDR report key: 23304683 · Received October 15, 2025

Report

Report Number
3006630150-2025-08998
Event Type
Injury
Date Received
October 15, 2025
Date of Event
September 25, 2025
Report Date
November 11, 2025
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729985099
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: PRODUCT FAMILY: SCS-LINEAR LEADS. UPN: M365SC2218500. MODEL: SC-2218-50. SERIAL: (B)(6). BATCH: 7111344/7111330. UDI: (B)(4). UDI: (B)(4).

Additional Manufacturer Narrative · 0

BLOCK B3: APPROXIMATED BASED ON THE DATE THE MANUFACTURER BECAME AWARE OF THE EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT REVISION PROCEDURE DUE TO AN UNKNOWN REASON. NO FURTHER INFORMATION HAS BEEN OBTAINED DESPITE GOOD FAITH EFFORTS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT REVISION PROCEDURE DUE TO AN UNKNOWN REASON. NO FURTHER INFORMATION HAS BEEN OBTAINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2358944 WAVEWRITER ALPHA? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1232 545609 08714729985099

Patients

Seq Age Sex Outcome Treatment
1 69 YR Male Required Intervention