FDA Adverse Event Injury Summary report: N

PRECISION SPECTRA®

MDR report key: 3972750 · Received August 1, 2014

Report

Report Number
3006630150-2014-01727
Event Type
Injury
Date Received
August 1, 2014
Date of Event
July 2, 2014
Report Date
July 8, 2014
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WY, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
450621 PRECISION SPECTRA® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1132 NA

Patients

Seq Age Sex Outcome Treatment
1 50 YR Required Intervention