BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDTRONIC SYNCHROMED INFUSION PUMP

    MDR report key: 1661583 · Received April 13, 2010

    Report

    Report Number
    MW5015560
    Event Type
    Death
    Date Received
    April 13, 2010
    Date of Event
    December 7, 2009
    Report Date
    April 13, 2010
    Manufacturer
    MEDTRONIC
    Product Code
    LKK
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    GA, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    PT DIED 5 DAYS AFTER MEDTRONIC PUMP INSERTED. DIAGNOSIS OR REASON FOR USE: PAIN CONTROL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC SYNCHROMED INFUSION PUMP PAIN PUMP LKK MEDTRONIC 8637-40 N218537009

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Death