Brand Name | ALGOVITA SPINAL CORD STIMULATION |
Type of Device | STIMULATOR, SPINAL CORD, TOTALLY IMPLANTABLE (PAIN RELIEF) |
Manufacturer (Section D) |
NUVECTRA CORPORATION |
10675 naples street ne |
blaine MN 55449 |
|
MDR Report Key | 8461715 |
MDR Text Key | 140459593 |
Report Number | 3010309840-2019-00175 |
Device Sequence Number | 1 |
Product Code |
LGW
|
Combination Product (y/n) | N |
PMA/PMN Number | P130028 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,health |
Type of Report
| Initial,Followup |
Report Date |
07/25/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/28/2019 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 10/24/2020 |
Device Model Number | 1124-60T |
Device Catalogue Number | 1124-60T |
Device Lot Number | W4571083, W4562966 |
Was Device Available for Evaluation? |
Yes
|
Date Returned to Manufacturer | 02/28/2019 |
Date Manufacturer Received | 02/27/2019 |
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
Patient Age | 78 YR |
|
|