FDA Adverse Event Malfunction Summary report: N

SYNCHROMED EL

MDR report key: 1061978 · Received June 16, 2008

Report

Report Number
6000030-2008-03254
Event Type
Malfunction
Date Received
June 16, 2008
Date of Event
June 27, 2007
Report Date
May 19, 2008
Manufacturer
RICE CREEK MANUFACTURING
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT A VOLUME DISCREPANCY WAS NOTED AT REFILL. THE EXPECTED RESERVOIR VOLUME WAS 13 ML; THE HCP ASPIRATED 11 ML FROM THE RESERVOIR. ON THE DATE OF THAT REFILL, THE INTRATHECAL DOSE OF GABALON WAS INCREASED FROM 200 MCG/DAY TO 230 MCG/DAY FOR SPASM CONTROL. TWO SUBSEQUENT REFILLS WERE PERFORMED AND THE VOLUME DISCREPANCIES WERE REPORTED TO BE WITHIN NORMAL LIMITS (<25%).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED EL LKK RICE CREEK MANUFACTURING 8627L18 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention IMPLANTED:| PROGRAMMER MODEL PROGRAMMER LOT# UNKNOWN| EXPLANTED:| CATHETER MODEL 8711 LOT# N077018012