FDA Adverse Event
Injury
Summary report: N
PRECISION®
MDR report key: 2870388
·
Received December 12, 2012
Report
- Report Number
- 3006630150-2012-02324
- Event Type
- Injury
- Date Received
- December 12, 2012
- Date of Event
- October 9, 2012
- Report Date
- October 9, 2012
- Manufacturer
- BOSTON SCIENTIFIC NEUROMODULATION
- Product Code
- LGW
- PMA / PMN Number
- 030017
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
A GOOD FAITH EFFORT WAS MADE TO FOLLOW UP WITH THE PATIENT'S STATUS BUT WAS UNSUCCESSFUL.
Additional Manufacturer Narrative · 1
(B)(4): ADDITONAL INFORMATION WAS RECEIVED THAT THE PAIN MEDICATION WAS GIVEN FOR PRE-EXISTING PAIN.
Description of Event or Problem · 1
A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING POCKET SITE TENDERNESS AND PAIN. THE PATIENT WAS PRESCRIBED WITH PAIN MEDICATIONS.
Description of Event or Problem · 1
A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING POCKET SITE TENDERNESS AND PAIN. THE PATIENT WAS PRESCRIBED WITH PAIN MEDICATIONS.
Description of Event or Problem · 1
A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING POCKET SITE TENDERNESS AND PAIN. THE PATIENT WAS PRESCRIBED WITH PAIN MEDICATIONS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PRECISION® | SPINAL CORD STIMULATOR | LGW | BOSTON SCIENTIFIC NEUROMODULATION | SC-1110-02 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Required Intervention |