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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL - NEUROMODULATION (PUERTO RICO, LLC) EXTENSION, 60CM; SCS EXTENSION

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ST. JUDE MEDICAL - NEUROMODULATION (PUERTO RICO, LLC) EXTENSION, 60CM; SCS EXTENSION Back to Search Results
Model Number 3386
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Post Operative Wound Infection (2446)
Date of Event 01/09/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient had an infection at the leads and pocket incision.Surgical intervention was undertaken and the leads and extensions were explanted.
 
Additional Manufacturer Narrative
B3: event date is estimated.
 
Event or Problem Description
Additional information received reports that the patient's infection is now resolved.
 
Additional Manufacturer Narrative
The device history record was reviewed to ensure proper packaging and sterility.A review of the lot history record identified no manufacturing nonconformities issued to the reported device that would have contributed to this event.Based on the information provided a device problem was not identified, as a result a conclusive cause for the reported patient effect, and the relationship to the product, if any, cannot be determined.
 
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Brand Name
EXTENSION, 60CM
Common Device Name
SCS EXTENSION
Manufacturer (Section D)
ST. JUDE MEDICAL - NEUROMODULATION (PUERTO RICO, LLC)
lot a interior - #2 street km 67.5
santana industrial park
arecibo PR 00612
Manufacturer (Section G)
ST. JUDE MEDICAL - NEUROMODULATION (PUERTO RICO, LLC)
lot a interior - #2 street km 67.5
santana industrial park
arecibo PR 00612
Manufacturer Contact
sara speyerer
6901 preston road
plano, TX 75024
9723098000
MDR Report Key24240917
Report Number3006705815-2026-00702
Device Sequence Number15996343
Product Code LGW
UDI-Device Identifier05414734402330
UDI-Public(01)05414734402330(10)A000169593(17)270213
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
P010032
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
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) 04/24/2026
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 Number3386
Device Catalogue Number3386
Device Lot NumberA000169593
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 01/09/2026
Supplement Date Received by Manufacturer03/24/2026
04/21/2026
Initial Report FDA Received Date02/02/2026
Supplement Report FDA Received Date04/14/2026
04/24/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/13/2025
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 Other;
Patient SexFemale
Patient Weight49 KG
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