MAUDE Adverse Event Report: BOSTON SCIENTIFIC NEUROMODULATION CORPORATION Precision?; stimulator, spinal-cord, totally implanted for pain relief

Model Number	SC-1110-02
Medical Device Problem Code	Battery Problem (2885)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	01/01/2017
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that the patient's ipg had reached end of life.The patient underwent a procedure wherein the implantable pulse generator (ipg) and spinal cord stimulator (scs) leads were explanted.The explanted devices were discarded by the medical facility and will not be returned.
Additional Manufacturer Narrative
Block b3: exact date unknown, event occurred in 2017.Block d.2b; additional applicable product code: qrb.Block d.6b; explant date: 2017.Additional suspect medical device components involved in the event: model number/catalog number: sc-221-508.Serial number: (b)(6).Batch/lot number: 17590228.Model/catalog description: linear st lead kit 50 cm.Unique identifier (udi)#: (b)(4).Model number/catalog number: sc-2218-50.Serial number: (b)(6).Batch/lot number: 17590228.Model/catalog description: linear st lead kit 50 cm.Unique identifier (udi)(b)(4).Investigation results: all explanted devices were not returned for analysis; therefore, a technical analysis could not be performed.Device history record: it was confirmed that this device met manufacturing specification prior to distribution and there were no manufacturing deviations which could have contributed to the reported event.Investigation conclusion: all explanted devices were not returned for analysis and the complaint as reported could not be confirmed.Record review revealed no additional information related to all complaints.Therefore, this investigation is unable to determine a probable cause for the complaint and the conclusion code cause not established will be used.

• Brand Name: Precision?
• 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; 25155 rye canyon loop; valencia CA 91355
• Manufacturer Contact: ricardo amaro castro ; 25155 rye canyon loop; valencia, CA 91355 ; +1(320)800-7570
• MDR Report Key: 50817245
• Report Number: 3006630150-2026-06882
• Device Sequence Number: 16130613
• Product Code: LGW
• UDI-Device Identifier: 08714729767688
• UDI-Public: (01)08714729767688(17)160429(10)16913832
• Combination Product (Y/N): N
• Initial Reporter State: IN
• Initial Reporter Country: US
• PMA/510(K) Number: P030017
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2015
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 09/18/2026

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 Date: 04/29/2016
• Device Model Number: SC-1110-02
• Device Catalogue Number: SC-1110-02
• Device Lot Number: 16913832
• 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: 08/21/2026
• Initial Report FDA Received Date: 09/18/2026
• Date Device Manufactured: 04/29/2014
• 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 Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 47 YR
• Patient Sex: Male
• Patient Weight: 130 LB