FDA Adverse Event Injury Summary report: N

PRECISION SPECTRA®

MDR report key: 4061668 · Received September 4, 2014

Report

Report Number
3006630150-2014-01997
Event Type
Injury
Date Received
September 4, 2014
Date of Event
August 7, 2014
Report Date
August 7, 2014
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THE PATIENT DID NOT UNDERGO THE CT GUIDED ASPIRATION. IT WAS ALSO REPORTED THAT THERE WAS NO BLOOD CLOT, THE BATTERY WAS JUST ON ITS EDGE.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING DISCOMFORT AT THE POCKET SITE AND TROUBLE CHARGING THE IPG. THE PHYSICIAN FELT THAT IT WAS LIKELY A BLOOD CLOT IN THE IMPLANT SITE AND IPG WAS TOO DEEP THAT CAUSED DIFFICULTY CHARGING. THE PHYSICIAN DID NOT KNOW WHAT CAUSED THE BLOOD CLOT. THE PATIENT WAS SENT FOR A CT GUIDED ASPIRATION OF THE POCKET SITE. THE PATIENT UNDERWENT A REVISION PROCEDURE AND WAS DOING WELL POSTOPERATIVELY.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS EXPERIENCING DISCOMFORT AT THE POCKET SITE AND TROUBLE CHARGING THE IPG. THE PHYSICIAN FELT THAT IT WAS LIKELY A BLOOD CLOT IN THE IMPLANT SITE AND IPG WAS TOO DEEP THAT CAUSED DIFFICULTY CHARGING. THE PHYSICIAN DID NOT KNOW WHAT CAUSED THE BLOOD CLOT. THE PATIENT WAS SENT FOR A CT GUIDED ASPIRATION OF THE POCKET SITE. THE PATIENT UNDERWENT A REVISION PROCEDURE AND WAS DOING WELL POSTOPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
541543 PRECISION SPECTRA® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1132 NA

Patients

Seq Age Sex Outcome Treatment
1 58 YR Required Intervention