FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 3123007 · Received May 21, 2013

Report

Report Number
3006630150-2013-01010
Event Type
Injury
Date Received
May 21, 2013
Date of Event
April 25, 2013
Report Date
April 25, 2013
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NM, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT HAD PAIN AT THE POCKET SITE. THE PATIENT UNDERWENT A POCKET REVISION AND DID WELL POSTOPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
224560 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 NA

Patients

Seq Age Sex Outcome Treatment
1 79 YR Required Intervention