FDA Adverse Event Injury Summary report: N

PRECISION SPECTRA®

MDR report key: 3924061 · Received July 9, 2014

Report

Report Number
3006630150-2014-01558
Event Type
Injury
Date Received
July 9, 2014
Date of Event
June 16, 2014
Report Date
June 16, 2014
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT NO FURTHER COURSE OF ACTION WILL BE TAKEN.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING THE IPG. THE PATIENT WILL UNDERGO A REVISION PROCEDURE.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING THE IPG. THE PATIENT WILL UNDERGO A REVISION PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
399550 PRECISION SPECTRA® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1132 NA

Patients

Seq Age Sex Outcome Treatment
1 47 YR Required Intervention