FDA Adverse Event Injury Summary report: N

SPECTRA WAVEWRITER?

MDR report key: 24677366 · Received March 24, 2026

Report

Report Number
3006630150-2026-01770
Event Type
Injury
Date Received
March 24, 2026
Date of Event
February 16, 2023
Report Date
May 15, 2026
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
Product Code
LGW
UDI-DI
08714729951254
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK B3: THE ESTIMATED EVENT DATE DERIVED FROM THE EXPLANT PROCEDURE OF DEVICES. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: MODEL NUMBER/CATALOG NUMBER: SC-2218-70, SERIAL NUMBER: (B)(6), BATCH/LOT NUMBER: 5090352, MODEL/CATALOG DESCRIPTION: LINEAR ST LEAD KIT 70 CM, UNIQUE IDENTIFIER (UDI) #: (B)(4). MODEL NUMBER/CATALOG NUMBER: SC-2218-70, SERIAL NUMBER: (B)(6), BATCH/LOT NUMBER: 5071830, MODEL/CATALOG DESCRIPTION: LINEAR ST LEAD KIT 70 CM, UNIQUE IDENTIFIER (UDI) #: (B)(4).

Additional Manufacturer Narrative · 0

BLOCK B3: THE ESTIMATED EVENT DATE DERIVED FROM THE EXPLANT PROCEDURE OF DEVICES. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: MODEL NUMBER/CATALOG NUMBER: SC-2218-70. SERIAL NUMBER: (B)(6). BATCH/LOT NUMBER: (B)(6). MODEL/CATALOG DESCRIPTION: LINEAR ST LEAD KIT 70 CM. UNIQUE IDENTIFIER (UDI) #: (B)(4). MODEL NUMBER/CATALOG NUMBER: SC-2218-70. SERIAL NUMBER: (B)(6). BATCH/LOT NUMBER: (B)(6). MODEL/CATALOG DESCRIPTION: LINEAR ST LEAD KIT 70 CM. UNIQUE IDENTIFIER (UDI) #: (B)(4).

Additional Manufacturer Narrative · 0

THE DEVICES SC-1160, SERIAL NUMBER: (B)(6), SC-2218-70; SERIAL NUMBER: (B)(6) AND SC-2218-70; SERIAL NUMBER: (B)(6) WERE NOT RETURNED FOR ANALYSIS; THEREFORE, A TECHNICAL ANALYSIS COULD NOT BE PERFORMED. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) CONFIRMED THAT THE DEVICES MET SPECIFICATION PRIOR TO SHIPPING. NO MANUFACTURING DEVIATIONS WERE NOTED THAT COULD HAVE CONTRIBUTED TO THE EVENT REPORTED. THERE IS NO COMPLAINT AGAINST THE FUNCTIONALITY OF THE DEVICES AND THE COMPLAINT AS REPORTED COULD NOT BE CONFIRMED. RECORD REVIEW REVEALED NO ADDITIONAL INFORMATION RELATED TO THE COMPLAINT. BASED ON A THOROUGH REVIEW OF THE REPORTED COMPLAINT, BOSTON SCIENTIFIC HAS ASSIGNED AN INVESTIGATION CONCLUSION CODE OF CAUSE NOT ESTABLISHED. BLOCK B3: THE ESTIMATED EVENT DATE DERIVED FROM THE EXPLANT PROCEDURE OF DEVICES. ADDITIONAL SUSPECT MEDICAL DEVICE COMPONENTS INVOLVED IN THE EVENT: MODEL NUMBER/CATALOG NUMBER: SC-2218-70. SERIAL NUMBER: (B)(6). BATCH/LOT NUMBER: 5090352. MODEL/CATALOG DESCRIPTION: LINEAR ST LEAD KIT 70 CM. UNIQUE IDENTIFIER (UDI) #: (B)(4). MODEL NUMBER/CATALOG NUMBER: SC-2218-70. SERIAL NUMBER: (B)(6). BATCH/LOT NUMBER: 5071830. MODEL/CATALOG DESCRIPTION: LINEAR ST LEAD KIT 70 CM. UNIQUE IDENTIFIER (UDI) #: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE SPINAL CORD STIMULATION (SCS) PATIENT UNDERWENT A REPLACEMENT PROCEDURE OF THE IMPLANTABLE PULSE GENERATOR (IPG) AND LEADS FOR AN UNSPECIFIED REASON. THE DEVICES WILL NOT BE RETURNED FOR ANALYSIS. FOLLOWING THE REPLACEMENT PROCEDURE, THE PATIENT FULLY RECOVERED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE SPINAL CORD STIMULATION (SCS) PATIENT UNDERWENT A REPLACEMENT PROCEDURE OF THE IMPLANTABLE PULSE GENERATOR (IPG) AND LEADS FOR AN UNSPECIFIED REASON. THE DEVICES WILL NOT BE RETURNED FOR ANALYSIS. FOLLOWING THE REPLACEMENT PROCEDURE, THE PATIENT FULLY RECOVERED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE SPINAL CORD STIMULATION (SCS) PATIENT UNDERWENT A REPLACEMENT PROCEDURE OF THE IMPLANTABLE PULSE GENERATOR (IPG) AND LEADS FOR AN UNSPECIFIED REASON. THE DEVICES WILL NOT BE RETURNED FOR ANALYSIS. FOLLOWING THE REPLACEMENT PROCEDURE, THE PATIENT FULLY RECOVERED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
275294 SPECTRA WAVEWRITER? STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SC-1160 357288 08714729951254

Patients

Seq Age Sex Outcome Treatment
1