FDA Adverse Event
Injury
Summary report: N
SYNCHROMED II
MDR report key: 1970134
·
Received January 11, 2011
Report
- Report Number
- 3004209178-2011-00271
- Event Type
- Injury
- Date Received
- January 11, 2011
- Report Date
- January 4, 2011
- Manufacturer
- MEDTRONIC PUERTO RICO OPERATIONS CO., JUNCOS
- 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).
Description of Event or Problem · 1
THE PATIENT'S PUMP "RAN DRY." THE PUMP DELIVERED MORPHINE 50 MG/ML. THE PATIENT EXPERIENCED DRUG WITHDRAWALS. SPECIFIC WITHDRAWAL SYMPTOMS WERE NOT REPORTED. PUMP OPTIONS WERE BEING CONSIDERED, INCLUDING FILLING THE PUMP WITH SALINE UNTIL A DRUG REFILL COULD BE PERFORMED. ADDITIONAL INFORMATION HAS BEEN REQUESTED. BUT WAS NOT AVAILABLE AS OF THE DATE OF THIS REPORT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SYNCHROMED II | LKK | MEDTRONIC PUERTO RICO OPERATIONS CO., JUNCOS | 8637-40 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other | CATHETER: MODEL 8709, LOT# J0177999R| IMPLANTED:| EXPLANTED: |