BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NUVECTRA CORPORATION

    MDR report key: 8701596 · Received June 14, 2019

    Report

    Report Number
    3010309840-2019-00213
    Event Type
    Injury
    Date Received
    June 14, 2019
    Date of Event
    May 10, 2019
    Report Date
    June 7, 2019
    Manufacturer
    NUVECTRA CORPORATION
    Product Code
    LGW
    PMA / PMN Number
    P130028
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED TO NUVECTRA THAT THE PATIENT EXPERIENCED EXTREME STOMACH PAIN AND CRAMP. AN X-RAY WAS PERFORMED AND SHOWED PROPER PLACEMENT. SUBSEQUENTLY, THE STIMULATOR WAS EXPLANTED. THE CAUSE OF PAIN IS UNKNOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    494562 NUVECTRA CORPORATION STIMULATOR, SPINAL CORD, TOTALLY IMPLANTABLE (PAIN RELIEF) LGW NUVECTRA CORPORATION 2412

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Other