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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: NEVRO CORPORATION SENZA; NEVRO SENZA
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NEVRO CORPORATION SENZA; NEVRO SENZA Back to Search Results
Model Number LEAD3005-70B
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Unspecified Infection (1930)
Date of Event 05/12/2017
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The device was explanted but was not returned.The manufacturing and sterilization records were reviewed and no non-conformities were found.
 
Event or Problem Description
It was reported to nevro that a patient had acquired an infection following an implant procedure.The patient was treated with oral antibiotics.There have been no further reports of complications.
 
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Brand Name
SENZA
Common Device Name
NEVRO SENZA
Manufacturer (Section D)
NEVRO CORPORATION
1800 bridge parkway
redwood city CA 94065
MDR Report Key7217579
Report Number3008514029-2018-00091
Device Sequence Number123290
Product Code LGW
UDI-Device Identifier00813426020404
UDI-Public00813426020404
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P130022
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Device Explanted Year2017
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 01/24/2018
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 Physician
Device Expiration Date02/09/2020
Device Model NumberLEAD3005-70B
Device Lot Number94394041
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/12/2017
Initial Report FDA Received Date01/24/2018
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)		 No
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient Age28 DA
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