FDA Adverse Event Malfunction Summary report: N

SYNCHROMED II

MDR report key: 1140903 · Received August 28, 2008

Report

Report Number
2182207-2008-05277
Event Type
Malfunction
Date Received
August 28, 2008
Date of Event
June 1, 2008
Report Date
July 28, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD EXPERIENCED A RETURN OF SYMPTOMS INCLUDING INCREASED BASELINE SPASTICITY. THE EVENT LOGS INDICATED THAT THERE HAD BEEN MULTIPLE MOTOR STALLS AND RECOVERY. THE EVENT LOGS ALSO INDICATED SAFE STATE, LOW BATTERY RESET AND "STOPPED PUMP PERIOD MAY EXCEED TUBE SET". THE PUMP CONTAINED BACLOFEN 2000 MCG/ML AT MINIMUM RATE WITH A DAILY DOSE OF 12.5 MCG/DAY. ADDITIONAL INFORMATION HAS BEEN REQUESTED FROM THE HCP, BUT WAS NOT AVAILABLE AS OF THE DATE OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II LKK MEDTRONIC NEUROMODULATION 863740 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention EXPLANTED:| CATHETER: MODEL 8703W| IMPLANTED:| PROGRAMMER: MODEL 8840