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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC NEUROMODULATION CORPORATION ARTISAN?; STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF

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BOSTON SCIENTIFIC NEUROMODULATION CORPORATION ARTISAN?; STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF Back to Search Results
Model Number SC-8216-70
Medical Device Problem Codes Inappropriate/Inadequate Shock/Stimulation (1574); Unexpected Therapeutic Results (1631); Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Nerve Damage (1979); Undesired Nerve Stimulation (1980); Pain (1994)
Date of Event 10/03/2023
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that the patient sustained a nerve damage following an implant procedure.It was also stated that the patient was experiencing inadequate pain relief and severe pain, electric shocking sensations, and spasms across the back of the waist band area despite program optimization.The patient underwent a procedure wherein the implantable pulse generator (ipg) and spinal cord stimulator (scs) leads were explanted.
 
Additional Manufacturer Narrative
Additional suspect medical device component involved in the event: product family: scs-ipg-r-mri, upn: m365sc12160, model: sc-1216, serial: (b)(6), batch: 582711, udi: (b)(4).
 
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Brand Name
ARTISAN?
Common Device Name
STIMULATOR, SPINAL-CORD, TOTALLY IMPLANTED FOR PAIN RELIEF
Manufacturer (Section D)
BOSTON SCIENTIFIC NEUROMODULATION CORPORATION
25155 rye canyon loop
valencia CA 91355
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
road 698, lot no. 12
dorado PR 00646 -260
*   00646-2602
Manufacturer Contact
erik sherburne
25155 rye canyon loop
valencia, CA 91355
7632920920
MDR Report Key24365271
Report Number3006630150-2026-00935
Device Sequence Number19174091
Product Code LGW
UDI-Device Identifier08714729779919
UDI-Public(01)08714729779919(17)241128(10)7073841
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P030017
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Device Explanted Year2024
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) 02/17/2026
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 Lay User/Patient
Device Expiration Date11/28/2024
Device Model NumberSC-8216-70
Device Catalogue NumberSC-8216-70
Device Lot Number7073841
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 01/28/2026
Initial Report FDA Received Date02/17/2026
Date Device Manufactured11/29/2022
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 Age49 YR
Patient SexFemale
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