FDA Adverse Event Malfunction Summary report: N

SYNCHROMED II

MDR report key: 1003436 · Received February 21, 2008

Report

Report Number
3004209178-2008-00845
Event Type
Malfunction
Date Received
February 21, 2008
Date of Event
January 24, 2008
Report Date
January 24, 2008
Manufacturer
MEDTRONIC PUERTO RICO OPERATIONS CO.
Product Code
LKK
PMA / PMN Number
P860004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

THE HCP REPORTED THAT, AT IMPLANTATION, THERE WAS PASSIVE CEREBROSPINAL FLUID BACKFLOW THROUGH THE CATHETER; HE WAS ALSO ABLE TO FLUSH WATER THROUGH THE CATHETER ACCESS PORT PRIOR TO CONNECTING THE CATHETER TO THE PUMP. HOWEVER, AFTER CONNECTING THE CATHETER TO THE PUMP, THE HCP HAD DIFFICULTY ASPIRATING FLUID THROUGH THE CATHETER ACCESS PORT. THE PUMP REMAINS IMPLANTED. NO PT SYMPTOMS WERE REPORTED. THE TYPE OF MEDICATION, CONCENTRATION, AND DAILY DOSE BEING ADMINISTERED VIA THE PUMP WERE NOT REPORTED; DEVICE REGISTRATION SYSTEM INDICATES MORPHINE. A FOLLOW-UP REPORT WILL BE SUBMITTED IF ADDITIONAL INFO BECOMES AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II LKK MEDTRONIC PUERTO RICO OPERATIONS CO. 8637 NA

Patients

Seq Age Sex Outcome Treatment
1 51 YR EXPLANTED:| CATHETER MODEL 8731SC| PROGRAMMER MODEL 8840| IMPLANTED:| EXPLANTED: