FDA Adverse Event Injury Summary report: N

UNKNOWN IMPLANTABLE NEUROSTIMULATOR

MDR report key: 4323401 · Received December 11, 2014

Report

Report Number
3007566237-2014-03599
Event Type
Injury
Date Received
December 11, 2014
Report Date
November 20, 2014
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
MHY
PMA / PMN Number
P960009
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
HK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

IT WAS NOT POSSIBLE TO ASCERTAIN SPECIFIC DEVICE INFORMATION FROM THE ARTICLE OR TO MATCH THE EVENTS REPORTED WITH PREVIOUSLY REPORTED EVENTS. CORRESPONDENCE HAS BEEN SENT TO THE AUTHOR OF THE ARTICLE INQUIRING ABOUT PATIENT INFORMATION AND ADDITIONAL INFORMATION REGARDING THE REPORTED EVENTS. CONCOMITANT PRODUCT: PRODUCT ID NEU_UNKNOWN_LEAD, LOT# UNKNOWN, PRODUCT TYPE LEAD. (B)(4).

Description of Event or Problem · 1

CHAN, A.Y., YEUNG, J.H., MOK, V.C., IP, V., WONG, A., KUO, S.H., CHAN, D., ZHU, X.L., WONG, E., LAU, C., WONG, R., TANG, V., LAU, C., POON, W.S. SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE: EVIDENCE FOR EFFECTIVENESS AND LIMITATIONS FROM 12 YEARS' EXPERIENCE. HONG KONG MEDICAL JOURNAL = XIANGGANG YI XUE ZA ZHI / HONG KONG ACADEMY OF MEDICINE. 2014. DOI: 10.12809/HKMJ144242. SUMMARY: A COHORT OF PATIENTS WITH PARKINSON¿S DISEASE RECEIVED SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION FROM (B)(6) 1998 TO (B)(6) 2010. PATIENT ASSESSMENT DATA BEFORE AND AFTER THE OPERATION WERE COLLECTED PROSPECTIVELY. FORTY-ONE PATIENTS (21 MALE AND 20 FEMALE) WITH PARKINSON¿S DISEASE UNDERWENT BILATERAL SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION AND WERE FOLLOWED FOR A MEDIAN INTERVAL OF 12 MONTHS. FOR THE WHOLE GROUP, THE MEAN IMPROVEMENTS OF UNIFIED PARKINSON¿S DISEASE RATING SCALE (UPDRS) PARTS II AND III WERE 32.5% AND 31.5%, RESPECTIVELY (P<(><<)>0.001). THROUGHOUT THE YEARS, A MULTIDISCIPLINARY TEAM WAS GRADUALLY BUILT. THE DEEP BRAIN STIMULATION PROTOCOL EVOLVED AND WAS SUBSTANTIATED BY UPDATED PATIENT SELECTION CRITERIA AND OUTCOME ASSESSMENT, INTEGRATED IMAGING AND NEUROPHYSIOLOGICAL TARGETING, REFINEMENT OF SURGICAL TECHNIQUE AS WELL AS THE ACCUMULATION OF EXPERIENCE IN DEEP BRAIN STIMULATION PROGRAMMING. MOST OF THE STRUCTURAL IMPROVEMENT OCCURRED BEFORE MID-2005. PATIENTS RECEIVING THE OPERATION BEFORE (B)(6) 2005 (19 CASES) AND AFTER (22 CASES) WERE COMPARED. THE IMPROVEMENTS IN UPDRS PART III WERE 13.2% AND 55.2%, RESPECTIVELY (P<(><<)>0.001). THERE WERE THREE OPERATIVE COMPLICATIONS (ONE LEAD MIGRATION, ONE CEREBRAL HAEMATOMA, AND ONE INFECTION) IN THE GROUP OPERATED BEFORE 2005. THERE WAS NO OPERATIVE MORTALITY. THE FUNCTIONAL STATE OF PARKINSON¿S DISEASE PATIENTS WITH MOTOR DISABILITIES REFRACTORY TO BEST MEDICAL TREATMENT IMPROVED SIGNIFICANTLY AFTER SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION. A DEDICATED MULTIDISCIPLINARY TEAM BUILDING, REFINED PROTOCOL FOR PATIENT SELECTION AND ASSESSMENT, IMPROVEMENT OF TARGETING METHODS, METICULOUS SURGICAL TECHNIQUE, AND EXPERIENCE IN PROGRAMMING ARE THE KEY FACTORS CONTRIBUTING TO THE IMPROVED OUTCOME. REPORTED EVENTS: ONE MALE PATIENT WITH DEEP BRAIN STIMULATION (DBS) FOR PARKINSON¿S DISEASE EXPERIENCED AN INFECTION THREE WEEKS AFTER THE DBS OPERATION IN 2001. IT WAS NOTED THAT APART FROM ABSCESS FORMATION IN THE CHEST WALL WHERE THE PULSE GENERATOR WAS IMPLANTED, MRI BRAIN SHOWED CONTRAST ENHANCEMENT AROUND THE DBS ELECTRODES. ALL THE HARDWARE, INCLUDING THE PULSE GENERATOR AND DBS LEADS, WERE REMOVED AND THE PATIENT RECEIVED A COURSE OF ANTIBIOTICS. THE PATIENT RECEIVED DBS AGAIN IN 2006 AND ENJOYED GOOD EFFECT. THE SOURCE LITERATURE INCLUDED THE FOLLOWING DEVICE SPECIFICS: IMPLANTABLE NEUROSTIMULATORS ITREL II MODEL 7424, SOLETRA MODEL 7426, OR KINETRA MODEL 7428 FURTHER INFORMATION HAS BEEN REQUESTED; A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF ADDITIONAL INFORMATION IS RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
806105 UNKNOWN IMPLANTABLE NEUROSTIMULATOR STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR MHY MEDTRONIC NEUROMODULATION NEU_INS_STIMULATOR UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention