FDA Adverse Event Injury Summary report: N

SYNCHROMED II

MDR report key: 2250657 · Received September 13, 2011

Report

Report Number
3004209178-2011-07792
Event Type
Injury
Date Received
September 13, 2011
Date of Event
August 1, 2011
Report Date
January 26, 2012
Manufacturer
MDT PUERTO RICO OPERATIONS CO
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT HAD EXPERIENCED WOUND DEHISCENCE. IT WAS LATER REPORTED THAT THE PATIENT ACQUIRED AN INFECTION FROM THE WOUND DEHISCENCE. THE PATIENT'S PUMP SYSTEM WAS EXPLANTED. IT WAS LATER STATED THAT A "BED-SORE-LIKE SKIN CONDITION" HAD BEEN NOTED AT THE FORMER POCKET SITE IN THE ABDOMEN; THE PATIENT WAS TREATED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION: IT WAS NOTED THAT THE PATIENT HAD RECOVERED PER AN ASSESSMENT ON (B)(6) 2011, IN REGARDS TO WOUND MACERATION.

Description of Event or Problem · 1

THE DATE OF ONSET OF WOUND DEHISCENCE AND INFECTION WAS (B)(6) 2011. THE SEVERITY WAS STATED AS "MILD". THE PATIENT WAS HOSPITALIZED ON (B)(6) 2011 FOR PUS OOZING FROM A SURGICAL WOUND ON HIS BACK; HE WAS TREATED WITH ANTIBIOTIC IV AND THE WOUND WAS CLEANSED. UNASYN S, 3G/DAY, WAS ALSO ADMINISTERED INTRAVENOUSLY FROM (B)(6) 2011. NO IMPROVEMENT WAS OBSERVED. IT WAS STATED THAT THERE WAS "WITHDRAWAL ON (B)(6)". IT WAS NOT CLEAR WHETHER THIS WAS IN REFERENCE TO WITHDRAWAL SYMPTOMS OR EXPLANT OF THE DEVICE. NO PROBLEMS WERE OBSERVED DURING THE POST-OPERATIVE PERIOD. THE WOUND HEALED AS OF (B)(6) 2011 AND THE PATIENT WAS RE-IMPLANTED ON (B)(6) 2011.

Description of Event or Problem · 1

IT WAS REPORTED, THE FAMILY DISCOVERED A DEHISCENCE IN THE PUMP POCKET LOCATED ON THE PATIENT'S BACK. THEY "TOOK A WAIT-AND-SEE APPROACH" SUBSEQUENTLY. WITH REGARD TO THE WOUND DEHISCENCE IN THE BACK, AN INFECTION TOOK HOLD WITHIN THE PUMP POCKET FROM WHICH PUS SEEMED TO DISCHARGE AND RESULTING IN THE DEHISCENCE. ALTHOUGH, THE SITE HAD NOW HARDENED ONCE AGAIN, WITHDRAWAL OR SIMILAR SUCH SYMPTOMS HAD NOT BEEN OBSERVED. THE CAUSE OF THE WOUND DEHISCENCE WAS UNKNOWN. HCP NOTED THE INFECTION HAD INITIATED FROM THE DEHISCENCE IN THE PUMP POCKET ON THE PATIENT'S BACK AND THE CONDITION HAD NOT BEEN AMELIORATED BY TREATMENT, HENCE, FOR SAFETY REASONS, THE REMOVAL OF THE PUMP SYSTEM WAS DECIDED. THE DATE OF ONSET OF INFECTION WAS AFTER (B)(6) 2011. THE PATIENT WAS HOSPITALIZED. THE PATIENT, POST-PUMP REMOVAL, HAD DEVELOPED SYMPTOMS IN THE ABDOMINAL POCKET AREA ANALOGOUS TO BED SORES; THESE WERE BEING TREATED. DATE OF ONSET OF DECUBITUS WAS AFTER (B)(6) 2011. OUTCOME WAS NOTED AS NOT RECOVERED. THE INFECTION WAS NOTED AS BEING UNRELATED TO DRUG, HOWEVER, IT WAS UNKNOWN IF THE INFECTION WAS RELATED TO THE PATIENT'S DEVICE SYSTEM OR PROCEDURE. AS OF (B)(6), THE DAILY DOSE WAS SUBSEQUENTLY REDUCED, TAKING INTO CONSIDERATION THE SYSTEM REMOVAL. THUS, NO WITHDRAWAL SYMPTOMS WERE ANTICIPATED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION REPORTED THAT THE PATIENT WAS PLACED ON UNASYN 3 GRAMS IV FOR ADVERSE EVENT. IT WAS FURTHER STATED THAT ON (B)(6) 2011 PATIENT HAD AN INFECTION/WOUND DEHISCENCE. THE SEVERITY WAS REPORTED AS MILD, WITH A SERIOUSNESS SCORE OF ¿3-SERIOUS.¿ THERE WERE DOSE CHANGES AND DRUG THERAPY INTERVENTIONS. CAUSALITY WAS NOTED AS UNKNOWN. PATIENT HAD "WITHDRAWAL ON (B)(6) 2011." THE PATIENT WAS ON THIS ANTIBIOTIC FROM (B)(6) 2011 TO (B)(6) 2011. IT WAS REPORTED THAT ON (B)(6) 2011 THE CATHETER WAS REPLACED. IT WAS NOTED THAT THE PUMP WAS REPLACED ON (B)(6) 2011. IT WAS NOTED THAT THE PATIENT RECOVERED ON (B)(6) 2011.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II PUMP, INFUSION, IMPLANTED, PROGRAMMABLE LKK MDT PUERTO RICO OPERATIONS CO 8637-20 NA

Patients

Seq Age Sex Outcome Treatment
1 15 YR Hospitalization| R EXPLANTED:| IMPLANTED:| CATHETER: MODEL CATHETER, LOT# UNK