FDA Adverse Event Injury Summary report: N

ISOMED NON-PROGRAMMABLE PUMP

MDR report key: 1080193 · Received July 22, 2008

Report

Report Number
2182207-2008-04222
Event Type
Injury
Date Received
July 22, 2008
Date of Event
January 1, 2008
Report Date
June 23, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P990034
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN RETURNED TO THE MANUFACTURER FOR ANALYSIS WHICH IS NOT COMPLETE AS OF THE DATE OF THIS REPORT. A FOLLOW-UP REPORT WILL BE SENT WHEN THE ANALYSIS IS COMPLETE.

Description of Event or Problem · 1

THE PATIENT WAS REFERRED FOR OVERINFUSION SYMPTOMS (RESPIRATORY FAILURE); SHORTLY AFTERWARDS, FOLLOWED BY SYMPTOMS OF ABSENCE OF THERAPY. THE PHYSICIAN FOUND THE RESERVOIR EMPTY. THE PHYSICIAN FILLED THE PUMP WITH 10 MLS; 3 DAYS LATER, THE PHYSICIAN FOUND THE PUMP EMPTY. THE PUMP WAS EXPLANTED. THERE WAS NO PATIENT INJURY. THE PATIENT WAS "WELL". THE PUMP WAS USED TO DELIVER MORPHINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ISOMED NON-PROGRAMMABLE PUMP LKK MEDTRONIC NEUROMODULATION 8472 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Life Threatening| R