FDA Adverse Event Malfunction Summary report: N

SYNCHROMED II

MDR report key: 1180913 · Received September 23, 2008

Report

Report Number
2182207-2008-06041
Event Type
Malfunction
Date Received
September 23, 2008
Date of Event
August 1, 2008
Report Date
August 28, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PUMP HAD MORE VOLUME THAN EXPECTED. THE EXPECTED RESERVOIR VOLUME WAS 0 MLS; THE ACTUAL WAS 35 MLS. THE PUMP WAS CONFIRMED TO BE FLIPPED VIA AN X-RAY OR CT SCAN (DATE NOT REPORTED). NO PT SYMPTOMS WERE REPORTED. THE MEDICATION BEING DELIVERED VIA THE PUMP WAS NOT REPORTED. ADDITIONAL INFO HAS BEEN REQUESTED FROM THE HEALTH CARE PROFESSIONAL, A FOLLOW-UP REPORT WILL BE SENT IF ADDITIONAL INFO BECOMES AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II LKK MEDTRONIC NEUROMODULATION 8637-40 NA

Patients

Seq Age Sex Outcome Treatment
1 65 YR CATHETER: MODEL 8709SC| EXPLANTED:| IMPLANTED:| PROGRAMMER: MODEL 8840