FDA Adverse Event Malfunction Summary report: N

SYNCHROMED II

MDR report key: 2322647 · Received October 13, 2011

Report

Report Number
3007566237-2011-08868
Event Type
Malfunction
Date Received
October 13, 2011
Date of Event
September 8, 2011
Report Date
October 12, 2011
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). FINAL ANALYSIS OF THE PUMP REVEALED BATTERY RESISTANCE HIGH. PER ANALYSIS, 'IN HOUSE BATTERY TESTER PAR 273A REPORTS R=422 OHMS. = (-2.86V - -0.747V) / (0.00002A - 0.00502A) OCV = 3.02".

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS REPLACED. THE DEVICE WAS RETURNED FOR DISPOSAL. NO PT SYMPTOMS WERE REPORTED. THE PUMP WAS USED TO DELIVER LIORESAL.

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 24 YR EXPLANTED:| IMPLANTED:| CATHETER: MODEL 8709, LOT# N077234009