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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC NEUROMODULATION VERCISE GENUS; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS

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BOSTON SCIENTIFIC NEUROMODULATION VERCISE GENUS; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS Back to Search Results
Model Number DB-1216
Device Problems High impedance (1291); Unexpected Therapeutic Results (1631)
Patient Problems Movement Disorder (4412); Speech Disorder (4415); Unspecified Musculoskeletal problem (4535)
Event Date 09/18/2023
Event Type  Injury  
Event Description
It was reported the patient experienced a return of their pre-implant bradykinesia, rigidity, and slowness of speech.The physician observed the presence of high impedance measurements.The patient underwent a revision procedure where the implantable pulse generator (ipg) was replaced.
 
Manufacturer Narrative
The returned ipg was linked to a clinician programmer (cp) and high impedance measurements were observed.X-ray inspection of the ipg revealed a fractured feedthru ground wire.Engineers concluded the cause of the high impedances and the resulting impact to the patient therapy was the result of the fractured/broken proximal feedthru wire that connects to the case of the ipg.If the proximal feedthru wire that is connected to the case is compromised, stimulation capability will be compromised (as well as mri immunity) and monopolar impedance measurements will report high.
 
Event Description
It was reported the patient experienced a return of their pre-implant bradykinesia, rigidity, and slowness of speech.The physician observed the presence of high impedance measurements.The patient underwent a revision procedure where the implantable pulse generator (ipg) was replaced.
 
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Brand Name
VERCISE GENUS
Type of Device
STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN SYMPTOMS
Manufacturer (Section D)
BOSTON SCIENTIFIC NEUROMODULATION
25155 rye canyon loop
valencia CA 91355
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
cashel road
clonmel
EI  
Manufacturer Contact
erik sherburne
25155 rye canyon loop
valencia, CA 91355
7632920920
MDR Report Key17980940
MDR Text Key326234630
Report Number3006630150-2023-06441
Device Sequence Number1
Product Code NHL
Combination Product (y/n)N
Reporter Country CodeNL
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 02/05/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model NumberDB-1216
Device Catalogue NumberDB-1216
Device Lot Number549426
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/16/2023
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 09/27/2023
Initial Date FDA Received10/20/2023
Supplement Dates Manufacturer Received01/31/2024
Supplement Dates FDA Received02/05/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/30/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age63 YR
Patient SexMale
Patient Weight80 KG
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