FDA Adverse Event Injury Summary report: N

KINETRA

MDR report key: 1181192 · Received September 30, 2008

Report

Report Number
3004209178-2008-06221
Event Type
Injury
Date Received
September 30, 2008
Date of Event
August 25, 2008
Report Date
September 4, 2008
Manufacturer
MEDTRONIC PUERTO RICO OPERATIONS CO.
Product Code
MHY
PMA / PMN Number
P960009
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE PATIENT WENT TO THE EMERGENCY ROOM BECAUSE SHE HAD A FEVER AND AN "EXPOSED LEAD WIRE" THROUGH HER HEAD THAT WAS OOZING. SHE WAS TRANSPORTED TO ANOTHER FACILITY AND SEEN BY A NEUROSURGEON. THE ENTIRE IMPLANTED SYSTEM WAS REMOVED. THE PATIENT WAS ON UNSPECIFIED INTRAVENOUS ANTIBIOTICS AS WELL AS ORAL AND HAD A FOLLOW-UP APPOINTMENT SCHEDULED. THE INFECTIOUS DISEASE REPORT SAID, THE INFECTION WAS DUE TO PSEUDOMONAS AERUGINOSA. ADDITIONAL INFO HAS BEEN REQUESTED, A FOLLOW-UP REPORT WILL BE SENT IF ADDITIONAL INFO BECOMES AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KINETRA MHY MEDTRONIC PUERTO RICO OPERATIONS CO. 7428 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention LEAD MODEL 3387S| PRGORAMMER MODEL 7436| EXPLANTED| EXPLANTED| EXTENSION MODEL 7482A