FDA Adverse Event Malfunction Summary report: N

PRECISION®

MDR report key: 4203819 · Received October 27, 2014

Report

Report Number
3006630150-2014-02477
Event Type
Malfunction
Date Received
October 27, 2014
Date of Event
July 8, 2014
Report Date
August 8, 2014
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
PMA / PMN Number
030017
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED THAT THE PATIENT UNDERWENT IPG REPLACEMENT PROCEDURE AND WAS REPORTEDLY DOING WELL POSTOPERATIVELY. THE EXPLANTED DEVICE WAS NOT RETURNED TO BSN AS IT WAS DISCARDED BY THE MEDICAL FACILITY. IT IS INDICATED THAT THE DEVICE 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.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING CHARGING ISSUES AFTER A NON-DEVICE RELATED SURGERY WHEREIN IT WAS REPORTED THAT ELECTROCAUTERY WAS USED DURING THE PROCEDURE. A BSN REPRESENTATIVE ANALYZED THE IPG DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. AN IPG REPLACEMENT HAS BEEN RECOMMENDED. MONOPOLAR ELECTROCAUTERY IS A KNOWN SOURCE OF HIGH VOLTAGE TRANSIENT SIGNAL AND CURRENT COMPANY LABELING WARNS AGAINST THE USE OF MONOPOLAR ELECTROCAUTERY. (PHYSICIAN¿S IMPLANT MANUAL 9055940-001).

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT WAS HAVING CHARGING ISSUES AFTER A NON-DEVICE RELATED SURGERY WHEREIN IT WAS REPORTED THAT ELECTROCAUTERY WAS USED DURING THE PROCEDURE. A BSN REPRESENTATIVE ANALYZED THE IPG DATABASE AND CONFIRMED PREMATURE BATTERY DEPLETION. AN IPG REPLACEMENT HAS BEEN RECOMMENDED. MONOPOLAR ELECTROCAUTERY IS A KNOWN SOURCE OF HIGH VOLTAGE TRANSIENT SIGNAL AND CURRENT COMPANY LABELING WARNS AGAINST THE USE OF MONOPOLAR ELECTROCAUTERY. (PHYSICIAN¿S IMPLANT MANUAL 9055940-001).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
683494 PRECISION® SPINAL CORD STIMULATOR LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1110-02 NA

Patients

Seq Age Sex Outcome Treatment
1 61 YR