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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL KIT TRIAL SLIM TIP LEAD, 50CM; DRG LEAD

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ABBOTT MEDICAL KIT TRIAL SLIM TIP LEAD, 50CM; DRG LEAD Back to Search Results
Model Number MN10350-50A
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Headache (1880)
Date of Event 12/11/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient experienced a csf leakage resulting in headache.As such, a blood patch was performed resolve the symptoms.The trial was aborted, and the leads were removed to address the issue.Investigation was unable to determine which of the leads attributed to the issue.
 
Additional Manufacturer Narrative
Additional components potentially involved in the event include: common device name: drg lead, model:mn10350-50a, udi: (b)(4), serial: (b)(6), batch:10965791.
 
Event or Problem Description
Additional information indicated the csf leak occurred at the l5 drg lead.
 
Additional Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.Based on the information received, the cause of the reported incident could not be conclusively determined.
 
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Brand Name
KIT TRIAL SLIM TIP LEAD, 50CM
Common Device Name
DRG LEAD
Manufacturer (Section D)
ABBOTT MEDICAL
6901 preston rd
plano TX 75024
Manufacturer (Section G)
ABBOTT MEDICAL
6901 preston rd
plano TX 75024
Manufacturer Contact
sara speyerer
6901 preston road
plano, TX 75024
9723098000
MDR Report Key23991891
Report Number1627487-2026-00076
Device Sequence Number10530624
Product Code PMP
UDI-Device Identifier05415067027139
UDI-Public(01)05415067027139(10)10586273(17)261030
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
P150004
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted 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,Followup,Followup
Report Date (Section B) 03/06/2026
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 Health Professional
Device Model NumberMN10350-50A
Device Catalogue NumberMN10350-50A
Device Lot Number10586273
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/11/2025
Supplement Date Received by Manufacturer01/08/2026
02/28/2026
Initial Report FDA Received Date01/07/2026
Supplement Report FDA Received Date02/02/2026
03/06/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured10/30/2024
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
Concomitant Medical Products
and Therapy/Usage Dates
DRG LEAD.
Outcome Attributed to Adverse Event Other;
Patient Age32 YR
Patient SexFemale
Patient Weight50 KG
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