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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL - NEUROMODULATION (PUERTO RICO, LLC) LAMITRODE TRICENTRUS 16 LEAD, 60 CM; SCS LEAD

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ST. JUDE MEDICAL - NEUROMODULATION (PUERTO RICO, LLC) LAMITRODE TRICENTRUS 16 LEAD, 60 CM; SCS LEAD Back to Search Results
Model Number 3292
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Wound Dehiscence (1154); Post Operative Wound Infection (2446); Fluid Discharge (2686)
Date of Event 03/17/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Date of event is estimated.
 
Event or Problem Description
It was reported that the patient experienced an open wound, suspected infection, and drainage at the ipg and lead site.The patient was administered antibiotics to address the issue.
 
Additional Manufacturer Narrative
D10 correction: medical product and therapy date was not initially filled out.E1 update: the reporter¿s information was updated.During processing of this incident, attempts were made to obtain complete patient information.Further information was requested but not received.
 
Event or Problem Description
Additional information indicates surgical intervention was undertaken on (b)(6) 2026 wherein the lead was explanted and replaced to address the issue.The patient was also administered iv antibiotics to address the issue.
 
Additional Manufacturer Narrative
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
LAMITRODE TRICENTRUS 16 LEAD, 60 CM
Common Device Name
SCS LEAD
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 Key24866192
Report Number3006705815-2026-02303
Device Sequence Number16075735
Product Code LGW
UDI-Device Identifier05415067047823
UDI-Public(01)05415067047823(10)A000180361(17)271105
Combination Product (Y/N)N
Initial Reporter StateNY
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) 05/21/2026
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 Number3292
Device Catalogue Number3292
Device Lot NumberA000180361
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 03/24/2026
Supplement Date Received by Manufacturer04/22/2026
05/21/2026
Initial Report FDA Received Date04/13/2026
Supplement Report FDA Received Date05/08/2026
05/21/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/05/2025
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
Concomitant Medical Products
and Therapy/Usage Dates
SCS IPG
Outcome Attributed to Adverse Event Other;
Patient Age34 YR
Patient SexFemale
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