FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 2874481 · Received December 14, 2012

Report

Report Number
3006630150-2012-02391
Event Type
Injury
Date Received
December 14, 2012
Date of Event
September 12, 2012
Report Date
September 12, 2012
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THE PATIENT UNDERWENT A POCKET REVISION AND WAS DOING WELL POST-OPERATIVELY.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WILL UNDERGO A POCKET REVISION DUE TO PAIN AT THE POCKET SITE AND INABILITY TO CHARGE THE IPG.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WILL UNDERGO A POCKET REVISION DUE TO PAIN AT THE POCKET SITE AND INABILITY TO CHARGE THE IPG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention