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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SURETEK?; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR

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BOSTON SCIENTIFIC NEUROMODULATION CORPORATION SURETEK?; STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR Back to Search Results
Model Number DB-4600-C
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Atrial Fibrillation (1729)
Date of Event 08/19/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that during a deep brain stimulation (dbs) implant procedure, after the burr hole covers were placed, the physician began cauterizing the dura prior to inserting the cannula as part of the procedure.At that point, the patient went into atrial fibrillation (afib), and the case was aborted.The burr hole caps were left in place in case the leads are re-implanted at a later time.The cause of the incident remains unknown; a computed tomography (ct) scan was performed and appeared normal.The patient has since recovered and was referred to cardiology.
 
Additional Manufacturer Narrative
Block d2b: additional applicable product codes: mhy.Additional suspect medical device components involved in the event: product family: dbs-lead fixation, upn: m365db4600c0, model: db-4600-c, serial: na, batch: 36735449, udi: (b)(4).
 
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Brand Name
SURETEK?
Common Device Name
STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR
Manufacturer (Section D)
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
25155 rye canyon loop
valencia CA 91355
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
4100 hamline avenue north
saint paul MN 55112 5798
Manufacturer Contact
erik sherburne
25155 rye canyon loop
valencia, CA 91355
7632920920
MDR Report Key23023322
Report Number3006630150-2025-07468
Device Sequence Number9820234
Product Code MHY
UDI-Device Identifier08714729820802
UDI-Public(01)08714729820802(17)270626(10)36814214
Combination Product (Y/N)N
Initial Reporter StateNC
Initial Reporter CountryUS
PMA/510(K) Number
P150031
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 09/11/2025
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? No
Operator of Device Lay User/Patient
Device Model NumberDB-4600-C
Device Catalogue NumberDB-4600-C
Device Lot Number36814214
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/19/2025
Initial Report FDA Received Date09/11/2025
Date Device Manufactured06/26/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age78 YR
Patient SexMale
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