FDA Adverse Event Injury Summary report: N

PRECISION SPECTRA

MDR report key: 8297067 · Received February 1, 2019

Report

Report Number
3006630150-2019-00331
Event Type
Injury
Date Received
February 1, 2019
Date of Event
December 28, 2018
Report Date
February 1, 2019
Manufacturer
BOSTON SCIENTIFIC NEUROMODULATION
Product Code
LGW
UDI-DI
08714729821526
PMA / PMN Number
P030017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

MODEL NUMBER/CATALOG NUMBER: SC-8216-70, SERIAL NUMBER: (B)(4), BATCH/LOT NUMBER: 7023684, MODEL/CATALOG DESCRIPTION: ARTISAN LEAD 70 CM. THE EXPLANTED DEVICES WERE NOT RETURNED TO BSN.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PATIENT HAD INADEQUATE STIMULATION. THE PATIENT UNDERWENT AN EXPLANT PROCEDURE AND WAS DOING WELL POSTOPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
90379 PRECISION SPECTRA STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF LGW BOSTON SCIENTIFIC NEUROMODULATION SC-1132 21263545 08714729821526

Patients

Seq Age Sex Outcome Treatment
1 54 YR Required Intervention