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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 Problem Intermittent Energy Output (4025)
Patient Problem Paresthesia (4421)
Event Date 01/22/2024
Event Type  malfunction  
Event Description
It was reported that the patient experienced a pins and needles sensation while charging the deep brain stimulation (dbs) implantable pulse generator (ipg).The database analysis performed identified a bluetooth fault code when charging the ipg.Noise from the charging field of the charger interferes with the bluetooth communication chip set, thus causing internal resets where the device stimulation momentarily turns off and then returns to normal operation.The ipg remains implanted in the patient and delivering therapy.
 
Event Description
It was reported that the patient experienced a pins and needles sensation while charging the deep brain stimulation (dbs) implantable pulse generator (ipg).The database analysis performed identified a bluetooth fault code when charging the ipg.Noise from the charging field of the charger interferes with the bluetooth communication chipset, thus causing internal resets where the device stimulation momentarily turns off and then returns to normal operation.The ipg remains implanted in the patient and delivering therapy.Additional information received indicates that a boston scientific representative, in consultation with the treating clinician, performed an ipg firmware update that has resolved the bluetooth fault code error when charging the ipg.The applicable firmware is model 9028506-102-00.
 
Event Description
It was reported that the patient experienced a pins and needles sensation while charging the deep brain stimulation (dbs) implantable pulse generator (ipg).The database analysis performed identified a bluetooth fault code when charging the ipg.Noise from the charging field of the charger interferes with the bluetooth communication chipset, thus causing internal resets where the device stimulation momentarily turns off and then returns to normal operation.The ipg remains implanted in the patient and delivering therapy.Additional information received indicates that a boston scientific representative, in consultation with the treating clinician, performed an ipg firmware update that has resolved the bluetooth fault code error when charging the ipg.The applicable firmware is model 9028506-102-00.
 
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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 Key18735727
MDR Text Key336508150
Report Number3006630150-2024-00798
Device Sequence Number1
Product Code NHL
UDI-Device Identifier08714729985044
UDI-Public08714729985044
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
P150031
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Consumer,Company Representative
Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date 04/26/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Model NumberDB-1216
Device Catalogue NumberDB-1216
Device Lot Number583362
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 01/26/2024
Initial Date FDA Received02/19/2024
Supplement Dates Manufacturer Received03/04/2024
04/01/2024
Supplement Dates FDA Received03/29/2024
04/26/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/30/2023
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 Age66 YR
Patient SexFemale
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