FDA Adverse Event Malfunction Summary report: N

SYNCHROMED II

MDR report key: 1840068 · Received September 15, 2010

Report

Report Number
3004209178-2010-07006
Event Type
Malfunction
Date Received
September 15, 2010
Date of Event
August 1, 2010
Report Date
August 30, 2010
Manufacturer
MDT PUERTO RICO OPERATIONS CO., JUNCOS
Product Code
LKK
PMA / PMN Number
P860004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

THE ACTUAL RESIDUAL PUMP VOLUME WAS GREATER THAN THE EXPECTED VOLUME; SPECIFIC VALUES WERE NOT PROVIDED. THE PUMP WAS "ALMOST FULL". IT WAS NOTED THAT THE PATIENT HAD BEEN GOING IN EVERY FEW WEEKS FOR INCREASES AND WAS UP TO 8MG/DAY; THE DEVICE SYSTEM WAS USED TO DELIVER MORPHINE. FOLLOW-UP WITH THE PATIENT'S PHYSICIAN WAS RECOMMENDED. ADDITIONAL INFORMATION HAS BEEN REQUESTED, A FOLLOW-UP REPORT WILL BE SENT IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II LKK MDT PUERTO RICO OPERATIONS CO., JUNCOS 8637-40 NA

Patients

Seq Age Sex Outcome Treatment
1 48 YR IMPLANTED:| EXPLANTED:| CATHETER: MODEL #8709SC, LOT #N248463004