FDA Adverse Event Death Summary report: N

SYNCHROMED II

MDR report key: 1061360 · Received June 17, 2008

Report

Report Number
2182207-2008-03272
Event Type
Death
Date Received
June 17, 2008
Date of Event
May 18, 2008
Report Date
May 20, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT EXPIRED. THE CAUSE OF DEATH WAS UNK. IT IS UNK IF AN AUTOPSY WAS PERFORMED. THE PUMP CONTAINED MORPHINE SULFATE 15MG/ML AT A DOSE OF 4.354 MG AND BUPIVICAINE 10 MG/ML.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II LKK MEDTRONIC NEUROMODULATION 863720 NA

Patients

Seq Age Sex Outcome Treatment
1 Death EXPLANTED| ACCESSORY MODEL 8590-1| EXPLANTED| PROGRAMMER MODEL 8840| CATHETER MODEL 8711