FDA Adverse Event Injury Summary report: N

PRECISION®

MDR report key: 3133303 · Received May 29, 2013

Report

Report Number
3006630150-2013-01077
Event Type
Injury
Date Received
May 29, 2013
Date of Event
March 26, 2013
Report Date
April 17, 2013
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT HAD BURNING SENSATION AND PAIN AT THE POCKET SITE. THE PATIENT UNDERWENT POCKET REVISION AND WAS DOING WELL FOLLOWING THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
235616 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 NA

Patients

Seq Age Sex Outcome Treatment
1 31 YR Required Intervention