FDA Adverse Event Injury Summary report: N

NEURX DIAPHRAGM PACING SYSTEM

MDR report key: 5266871 · Received December 1, 2015

Report

Report Number
3005868392-2015-00004
Event Type
Injury
Date Received
December 1, 2015
Date of Event
October 1, 2015
Report Date
October 27, 2015
Manufacturer
SYNAPSE BIOMEDICAL INC.
Product Code
OIR
UDI-DI
00852184003281
PMA / PMN Number
H100006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
1

Narratives

Description of Event or Problem · 1

PATIENT HAD WIRES PROTRUDING FROM THE SKIN. ELECTRODES VISIBLE IN OPEN WOUND NEAR SUB-XYPHOID EXIT/TUNNELING POINT. THE ELECTRODE WAS INITIALLY TUNNELED NEAR THE SKIN SURFACE, EVENTUALLY ERODED THROUGH THE SKIN, EXPOSING ELECTRODE UNDERNEATH. SURGEON RETRACTED THE ELECTRODES FROM LATERAL CHEST AREA TO SUB XIPHOID REGION WHERE THEY WERE TRIMMED AND REBLOCKED. PATIENT CONTINUES TO USE DPS SYSTEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
789411 NEURX DIAPHRAGM PACING SYSTEM DIAPHRAGMATIC/PHRENIC NERVE LAPAROSCOPICALLY-IMPLANTED STIMULATOR OIR SYNAPSE BIOMEDICAL INC. 20-0045 20-0045-120511-4-3 00852184003281

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention