FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 3131850 · Received May 29, 2013

Report

Report Number
3006630150-2013-01089
Event Type
Injury
Date Received
May 29, 2013
Date of Event
May 6, 2013
Report Date
May 6, 2013
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
ND, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING IRRITATION AND PAIN AT THE POCKET SITE. THE PATIENT UNDERWENT A POCKET REVISION WHEREIN THE IPG WAS RELOCATED. THE PATIENT WAS DOING WELL FOLLOWING THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
235124 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 NA

Patients

Seq Age Sex Outcome Treatment
1 80 YR Required Intervention