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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL QUATTRODE LEAD WIDE SPACED, 60 CM; SCS LEAD

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ABBOTT MEDICAL QUATTRODE LEAD WIDE SPACED, 60 CM; SCS LEAD Back to Search Results
Model Number 3166
Medical Device Problem Code Migration (4003)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/19/2026
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Date of event is estimated.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.
 
Event or Problem Description
It was reported that the patient's ipg migrated and the leads were pulling at their neck.As a result, surgical intervention was undertaken on (b)(6) 2026 wherein the ipg was repositioned, and all leads were sutured to address the issue.
 
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Brand Name
QUATTRODE LEAD WIDE SPACED, 60 CM
Common Device Name
SCS 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 Key25862052
Report Number1627487-2026-08999
Device Sequence Number17532469
Product Code LGW
UDI-Device Identifier05414734401661
UDI-Public(01)05414734401661(10)T00006112(17)260515
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 07/17/2026
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 Health Professional
Device Expiration Date05/15/2026
Device Model Number3166
Device Catalogue Number3166
Device Lot NumberT00006112
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 06/22/2026
Initial Report FDA Received Date07/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/15/2024
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
SCS EXTENSION (X2)
Outcome Attributed to Adverse Event Other;
Patient Age49 YR
Patient SexFemale
Patient Weight54 KG
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