FDA Adverse Event Injury Summary report: N

INDURA

MDR report key: 1040504 · Received May 9, 2008

Report

Report Number
6000030-2008-02516
Event Type
Injury
Date Received
May 9, 2008
Date of Event
January 1, 2008
Report Date
April 16, 2008
Manufacturer
RICE CREEK MANUFACTURING
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT'S CATHETER WAS LEAKING AT THE DISTAL END. THE CATHETER WAS OUT OF THE SPINAL CANAL. THE PT HAD A CSF LEAK. THE LAST 17 CM OF THE CATHETER WERE REPLACED. IT WAS INDICATED THAT THE PT BELIEVED HE WAS STILL GETTING SOME EFFECT, BUT HE FELT THE CATHETER WAS LEAKING AS WELL. THE PHYSICIAN PLANNED TO MAINTAIN THE CURRENT DOSE. THE CONCENTRATION AND DAILY DOSE OF LIORESAL BEING ADMINISTERED VIA THE PUMP WERE NOT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INDURA LKK RICE CREEK MANUFACTURING 8709SC NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention PROGRAMMER MODEL 8840 LOT# UNK| LOT# NGP311528H| IMPLANTABLE INFUSION PUMP MODEL 863720| IMPLANTED| EXPLANTED