DBS 3387 NA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2004-04-26 for DBS 3387 NA manufactured by Neuro.

Event Text Entries

[354304] Hcp reported pt developed wound infection and subdural empyema approximately two weeks after placement of right dbs. Craniotomy for evaluation of infection and removal of lead (generator left in place in 2002). Pt had declined replacement of lead at last visit in 2003. Hcp reported pt had severe diabetes that compromised wound healing at initial placement and led to wound/brain infection. The device was removed but not returned to the manufacturer for analysis.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2182207-2004-00526
MDR Report Key523113
Report Source05
Date Received2004-04-26
Date of Report2004-03-08
Date Mfgr Received2004-04-09
Date Added to Maude2004-05-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactBARBARA PAHL
Manufacturer Street710 MEDTRONIC PARKWAY
Manufacturer CityMINNEAPOLIS MN 554325604
Manufacturer CountryUS
Manufacturer Postal554325604
Manufacturer Phone7635050856
Manufacturer G1NEURO
Manufacturer Street800 53RD AVE NE
Manufacturer CityMINNEAPOLIS MN 55421
Manufacturer CountryUS
Manufacturer Postal Code55421
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDBS
Generic NameLEAD
Product CodeGYZ
Date Received2004-04-26
Model Number3387
Catalog NumberNA
Lot NumberUNK
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeUNKNOWN
Device Eval'ed by MfgrR
Implant FlagY
Date RemovedV
Device Sequence No1
Device Event Key512242
ManufacturerNEURO
Manufacturer Address800 53RD AVENUE NE MINNEAPOLIS MN 55421 US
Baseline Brand NameDBS
Baseline Generic NameLEAD FOR BRAIN STIMULATION
Baseline Model No3387
Baseline Catalog NoNA
Baseline IDNA
Baseline Device FamilySTIM DBS LEAD
Baseline Shelf Life ContainedY
Baseline Shelf Life [Months]48
Baseline PMA FlagY
Premarket ApprovalP9600
Baseline 510K PMNN
Baseline PreamendmentN
Baseline TransitionalN
510k ExemptN


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2004-04-26

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