FDA Adverse Event Injury Summary report: N

SYNCHROMED II

MDR report key: 2810236 · Received October 31, 2012

Report

Report Number
3007566237-2012-02588
Event Type
Injury
Date Received
October 31, 2012
Report Date
October 3, 2012
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

PRODUCT ID 8709SC, SERIAL# (B)(4), IMPLANTED: (B)(6) 2009, EXPLANTED: (B)(6) 2012, PRODUCT TYPE CATHETER. (B)(4).

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED REPORTED THAT THE CATHETER ¿KINKED AND BROKE¿ AND THE PATIENT DEVELOPED SPINAL FLUID HEADACHES. SHE WAS UNABLE TO GET TO HER NEEDED REHAB. IT WAS NOTED THAT THE PATIENT WAS VERY ACTIVE, AND THAT COULD BE THE CAUSE OF CATHETER ISSUES.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT EXPERIENCED DECREASED THERAPEUTIC BENEFIT OR PRESENTED WITH VISIBLE SIGNS AND/OR SYMPTOMS OF DECREASED THERAPEUTIC BENEFIT. BEGINNING (B)(6) 2011, THE PATIENT BEGAN EXPERIENCING INCREASED STIFFNESS. VERIFICATION OF PUMP CONTENTS, ADJUSTMENT OF DOSING AND CATHETER ACCESS PORT (CAP) ASPIRATION WERE ALL COMPLETED WITH NO IMPROVEMENT OF PATIENT SYMPTOMS. THE PATIENT HAD X-RAYS COMPLETED IN OCTOBER AND A SPIRAL CT COMPLETED ON (B)(6) 2011. THE CT SCAN WAS SIGNIFICANT FOR A CATHETER LEAK. THE PUMP AND CATHETER WERE REPLACED ON (B)(6) 2012. THE PATIENT IMPROVED AFTER THE REVISION. THE DEVICE SYSTEM WAS USED TO DELIVER BACLOFEN.

Description of Event or Problem · 1

IT WAS LATER REPORTED IT WAS A CATHETER BREAK IN THE PERIPHERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED II PUMP, INFUSION, IMPLANTED, PROGRAMMABLE LKK MEDTRONIC NEUROMODULATION 8637-20

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention