FDA Adverse Event Malfunction Summary report: N

PRECISION®

MDR report key: 3983608 · Received August 6, 2014

Report

Report Number
3006630150-2014-01780
Event Type
Malfunction
Date Received
August 6, 2014
Date of Event
July 10, 2014
Report Date
July 10, 2014
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THE PATIENT UNDERWENT AN IPG REPLACEMENT AND WAS REPORTEDLY DOING WELL POSTOPERATIVELY. THE PHYSICIAN SUSPECTED DEVICE MALFUNCTION.

Additional Manufacturer Narrative · 1

DEVICE EVALUATION INDICATED THAT THE IPG PASSED VISUAL, ELECTRICAL, PERFORMANCE AND PHOTOGRAPHIC IMAGING TESTS PERFORMED. DEVICE EXHIBITED NORMAL CHARGING AND DISCHARGING CHARACTERISTICS.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING THE IPG. A BSN REPRESENTATIVE ANALYZED THE IPG DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. THE PATIENT WILL UNDERGO AN IPG REPLACEMENT.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING THE IPG. A BSN REPRESENTATIVE ANALYZED THE IPG DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. THE PATIENT WILL UNDERGO AN IPG REPLACEMENT.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING DIFFICULTY CHARGING THE IPG. A BSN REPRESENTATIVE ANALYZED THE IPG DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. THE PATIENT WILL UNDERGO AN IPG REPLACEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
460821 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 NA

Patients

Seq Age Sex Outcome Treatment
1 63 YR