FDA Adverse Event Malfunction Summary report: N

PRECISION®

MDR report key: 3881814 · Received June 18, 2014

Report

Report Number
3006630150-2014-01320
Event Type
Malfunction
Date Received
June 18, 2014
Date of Event
May 7, 2014
Report Date
May 7, 2014
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT NO FURTHER COURSE OF ACTION WILL BE TAKEN. IT IS INDICATED THAT THE IPG WILL NOT BE RETURNED FOR EVALUATION; THEREFORE A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. A REVIEW OF THE DEVICE HISTORY RECORDS WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MED WATCH WILL BE FILED.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT¿ IPG DEPLETES QUICKLY. A BSN SALES REPRESENTATIVE ANALYZED THE DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. THE PATIENT WILL UNDERGO AN IPG REPLACEMENT PROCEDURE.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT¿ IPG DEPLETES QUICKLY. A BSN SALES REPRESENTATIVE ANALYZED THE DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. THE PATIENT WILL UNDERGO AN IPG REPLACEMENT PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
357402 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110 NA

Patients

Seq Age Sex Outcome Treatment
1