FDA Adverse Event Malfunction Summary report: N

SYNCHROMED

MDR report key: 1213770 · Received October 22, 2008

Report

Report Number
2182207-2008-06752
Event Type
Malfunction
Date Received
October 22, 2008
Date of Event
September 25, 2008
Report Date
September 26, 2008
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE CATHETER HAS BEEN RETURNED TO THE MFR 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

DURING SURGERY, THE PHYSICIAN NOTICED THE CATHETER WAS LEAKING. THE CATHETER WAS IMMEDIATELY EXPLANTED AND REPLACED. THERE WAS NO PT INJURY. FOLLOWING THE SURGERY, THE PT HAD A GOOD THERAPY OUTCOME.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 IMPLANTED:| CATHETER: MODEL 8709SC| EXPLANTED: