FDA Adverse Event Injury Summary report: N

SENZA

MDR report key: 7042997 · Received November 17, 2017

Report

Report Number
3008514029-2017-00326
Event Type
Injury
Date Received
November 17, 2017
Date of Event
November 8, 2017
Report Date
December 13, 2017
Manufacturer
NEVRO CORPORATION
Product Code
LGW
UDI-DI
00813426020015
PMA / PMN Number
P130022
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS EXPLANTED BUT WAS NOT RETURNED. THE MANUFACTURING AND STERILIZATION RECORDS WERE REVIEWED AND NO NON-CONFORMITIES WERE FOUND.

Additional Manufacturer Narrative · 1

FOLLOW-UP REPORT INDICATED THAT THE DEVICE WAS PROACTIVELY EXPLANTED DUE TO A WOUND HEALING ISSUE. THE CULTURE REPORT RESULTS FOR THE INITIAL REPORT OF INFECTION WAS NEGATIVE AND THE PATIENT DID NOT HAVE AN INFECTION. IT WAS NOTED THAT THE PATIENT HAS A HISTORY OF (B)(6) FROM A PREVIOUS KNEE REPLACEMENT SURGERY. THE DEVICE WAS EXPLANTED, BUT WAS NOT RETURNED. THE MANUFACTURING AND STERILIZATION RECORDS WERE REVIEWED AND NO NON-CONFORMITIES WERE FOUND.

Description of Event or Problem · 1

IT WAS REPORTED TO NEVRO THAT A PATIENT HAD ACQUIRED AN INFECTION FOLLOWING AN IMPLANT PROCEDURE. THE PATIENT WAS HOSPITALIZED AND PROVIDED WITH IV ANTIBIOTICS. THERE HAVE BEEN NO FURTHER REPORTS OF COMPLICATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
821053 SENZA NEVRO SENZA LGW NEVRO CORPORATION NIPG1500 9440249 00813426020015

Patients

Seq Age Sex Outcome Treatment
1 52 YR Other