FDA Adverse Event Malfunction Summary report: N

SYNCHROMED

MDR report key: 2244061 · Received August 24, 2011

Report

Report Number
3007566237-2011-06819
Event Type
Malfunction
Date Received
August 24, 2011
Date of Event
July 1, 2011
Report Date
July 29, 2011
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT A PT THOUGHT HIS PUMP WAS "EMPTYING OUT TOO FAST" AND THAT HE WAS GOING INTO MORPHINE WITHDRAWAL. THE RPTR STATED HE THOUGHT THE PT SAID HIS PUMP HAD FLIPPED OVER. THE PUMP CONTAINED MORPHINE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1