FDA Adverse Event Injury Summary report: N

ISOMED NON-PROGRAMMABLE PUMP

MDR report key: 1171214 · Received September 22, 2008

Report

Report Number
2182207-2008-05992
Event Type
Injury
Date Received
September 22, 2008
Date of Event
August 25, 2008
Report Date
August 25, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE 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

IT WAS REPORTED THE PT HAD THE PUMP REPLACED AS IT HAD BEEN UNDERINFUSING FOR "SEVERAL MONTHS". THE CONCENTRATION, DOSE, AND DRUG IN THE PUMP WERE NOT REPORTED. NO SYMPTOMS WERE REPORTED. THE PT RECOVERED WITHOUT SEQUELA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ISOMED NON-PROGRAMMABLE PUMP LKK MEDTRONIC NEUROMODULATION 8472-60-10 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention CATHETER MODEL CATHETER LOT# UNK| IMPLANTED| EXPLANTED