FDA Adverse Event Death Summary report: N

ADVANCED NEUROMODULATION SYSTEM, INC

MDR report key: 963795 · Received December 12, 2007

Report

Report Number
MW5004663
Event Type
Death
Date Received
December 12, 2007
Date of Event
July 3, 2007
Report Date
November 19, 2007
Manufacturer
ADVANCED NEUROMODULATION SYSTEMS, INC
Product Code
LGW
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IN 2007, PT RECEIVED THE IMPLANTATION OF AN ANS NEUROSTIMULATION DEVICE FOR CONTROL OF PAIN CAUSED BY MS BASED TRIGEMINAL NEURALGIA. AFTER USING THE DEVICE WITH QUESTIONABLE BENEFIT PT EXPERIENCED THE ONSET OF FACIAL PAIN THE FOLLOWING MONTH. THAT PAIN INCREASED TO A DEGREE THAT SHE HAD NEVER EXPERIENCED BEFORE THE IMPLANTATION. SHE ALSO BECAME DISORIENTED, REPEATING HERSELF, WITHOUT REALIZING SHE WAS DOING SO. THE DEVICE WAS OF NO HELP AND SEEMED TO MAKE MATTERS WORSE. ONLY MEDS, WELL BEYOND USUAL DOSAGES WERE OF SAME HELP. PT BECAME UNRESPONSIVE, WAS HOSPITALIZED, AND DIED TWELVE DAYS LATER, FROM RESPIRATORY FAILURE. RELATED TO NEEDED PAIN MEDS. PLEASE SEE LETTER OF 10/30/2007, ON FILE AND ATTACHED. ROUTE: IMPLANT, DATE OF USE: ONE MONTH IN 2007. DIAGNOSIS OR REASON FOR USE: MS BASED TRIGEMINAL NEURALGIA. EVENT ABATED AFTER USE STOPPED OR DOSE REDUCED: NO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADVANCED NEUROMODULATION SYSTEM, INC SPINAL CORD STIMULATOR/NEUROSTIMULATOR LGW ADVANCED NEUROMODULATION SYSTEMS, INC

Patients

Seq Age Sex Outcome Treatment
1 58 YR Death| H| L| O