FDA Adverse Event Injury Summary report: N

SYNCHROMED II

MDR report key: 1822432 · Received August 26, 2010

Report

Report Number
3007566237-2010-06490
Event Type
Injury
Date Received
August 26, 2010
Report Date
July 26, 2010
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4): ANALYSIS RESULTS WERE NOT AVAILABLE AT THE TIME OF THIS REPORT. A FOLLOW-UP REPORT WILL BE SENT WHEN ANALYSIS IS COMPLETED.

Description of Event or Problem · 1

THE PUMP AND CATHETER WERE EXPLANTED AND NOT REPLACED DUE TO INFECTION. SPECIFIC PT SYMPTOMS OF INFECTION AND DATE OF ONSET OF INFECTION WERE NOT REPORTED. THE PUMP DELIVERED MORPHINE 10 MG/ML AT 2 MG/DAY. THE PT RECOVERED WITHOUT SEQUELA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II LKK MEDTRONIC NEUROMODULATION 863740 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention CATHETER: MODEL 8709SC, LOT# J12170R15| EXPLANTED:| IMPLANTED: