FDA Adverse Event Injury Summary report: N

SYNCHROMED II

MDR report key: 2933247 · Received January 29, 2013

Report

Report Number
3004209178-2013-01077
Event Type
Injury
Date Received
January 29, 2013
Date of Event
October 10, 2012
Report Date
January 10, 2013
Manufacturer
MDT PUERTO RICO OPERATIONS CO
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

PUMP PASSED DISPENSE AND INFUSION ACCURACY TESTING. NO REAL SIGNIFICANT ISSUES FOUND WITH PUMP PERFORMANCE. A VISUAL NOTE WAS MADE BY THE LAB THAT THERE ARE EXCESSIVE NEEDLE MARKS NEAR THE CAP (CATHETER ACCESS PORT) SEPTUM. CATHETER WAS RETURNED IN TWO SEGMENTS. THE DISTAL END OF THE SPINAL SEGMENT WHICH INCLUDES THE DISPENSING HOLES WAS NOT RETURNED. MINOR BLEMISHES NOTED WHICH INCLUDE SOME INDENTS ON THE RETAINING RING FINGERS AND AN INDENT DOWN INSIDE OF THE CUP OF THE SC. ALSO NOTED WAS A SLIGHT ABRASION OVER THE 30 CM MARKER ON THE SPINAL SEGMENT. THESE BLEMISHES DID NOT AFFECT CATHETER PERFORMANCE.

Additional Manufacturer Narrative · 1

PRODUCT ID: 8709SC, SERIAL# (B)(4), IMPLANTED: (B)(6) 2012, EXPLANTED: (B)(6) 2013, PRODUCT TYPE: CATHETER. (B)(4). ANALYSIS RESULTS WERE NOT AVAILABLE AT THE TIME OF THIS REPORT. A FOLLOW-UP REPORT WILL BE SENT WHEN ANALYSIS IS COMPLETED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED REPORTED THAT THE PATIENT PRESENTED TO THE EMERGENCY ROOM AFTER A PUMP REFILL WITH OVERDOSE SYMPTOMS; THEIR CONDITION DETERIORATED, REQUIRING INTUBATION. THE PATIENT WAS IN THE INTENSIVE CARE UNIT (ICU), GOT BETTER, AND WAS SENT TO RECOVERY. THE PATIENT STOPPED BREATHING AND WAS SENT BACK TO ICU AND PUT BACK ON THE VENTILATOR. THE DECISION WAS MADE TO REMOVE THE PUMP AS A PRECAUTIONARY MEASURE DUE TO A POSSIBLE MALFUNCTION OF THE PUMP. (SEE ATTACHED USER FACILITY MEDWATCH). IT WAS NOTED THAT NO DIAGNOSTICS WERE PERFORMED. THE PUMP AND CATHETER WERE EXPLANTED ON (B)(6) 2013. THE REASON GIVEN FOR EXPLANT WAS "PATIENT MEDICAL ISSUES". THE PATIENT RECOVERED AND WAS RELEASED. ON (B)(6) 2013, THE PATIENT WAS EVALUATED AT THE CLINIC AND WAS REPORTED TO BE DOING WELL. THE HEALTH CARE PROVIDER (HCP) COULD NOT SAY THAT THE PUMP WAS WHAT CAUSED THE EVENT, BUT THE DECISION WAS MADE TO NOT CONTINUE THERAPY WITH THE PUMP AND A NEW PUMP WAS NOT GOING TO BE PLACED AT THAT POINT. ON (B)(6) 2013, THE PUMP WAS RELEASED BY THE HOSPITAL AND WAS TO BE RETURNED TO THE MANUFACTURER FOR ANALYSIS, SINCE THE PATIENT PRESENTED TO THE ER (EMERGENCY ROOM) JUST AFTER A PUMP REFILL. THE PUMP WAS PROGRAMMED TO MINIMUM FLOW RATE WHEN IT WAS OBTAINED BY THE HOSPITAL'S RISK MANAGEMENT. THE PUMP SYSTEM WAS BEING USED TO DELIVER COMPOUNDED BACLOFEN AND "OTHER". IT WAS NOTED THAT THE PATIENT RECOVERED WITHOUT SEQUELA.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT EXPERIENCED RESPIRATORY FAILURE AND AN ALTERED MENTAL STATUS FOLLOWING PUMP REFILLS. ON (B)(6) 2012, A REFILL WAS DONE AND WITHIN 24 HOURS THE PATIENT WAS ADMITTED TO THE INTENSIVE CARE UNIT (ICU) WITH RESPIRATORY FAILURE AND AN ALTERED MENTAL STATUS. THE PATIENT WAS VENTILATED. THE PATIENT WAS WEANED OFF ALL INTRATHECAL, INTRAVENOUS AND ORAL MEDICATIONS, CAME OFF OF THE VENTILATOR AND WAS DISCHARGED. THE DISCHARGE DIAGNOSIS WAS PROBABLE BACLOFEN REACTION/ALLERGY. NO DIAGNOSTICS WERE DONE DURING THIS HOSPITALIZATION. AT A REFILL ON (B)(6) 2013, THE EXPECTED RESIDUAL VOLUME WAS 13.9ML AND THE ACTUAL VOLUME WAS 0.5ML. IT WAS BELIEVED THAT BUPIVACAINE CONTRIBUTED TO THE PREVIOUS EVENT, SO THE PUMP WAS NOT REFILLED WITH IT. A 40% DECREASE WAS DONE. THE FOLLOWING DAY, THE PATIENT WENT TO THE EMERGENCY ROOM WITH AN ALTERED MENTAL STATUS AND BREATHING ISSUES. THE PATIENT WAS ADMITTED TO THE MEDICAL RESPIRATORY ICU FOR AND WAS VENTILATED. HE WAS BEING KEPT SEDATED. THE FOLLOWING DAY, THE PUMP WAS INTERROGATED AND WAS ALREADY MISSING 2ML OF FLUID. THE PUMP WAS PROGRAMMED AT A SLOW RATE, SO THIS WAS NOT POSSIBLE. A LEAK WAS REPORTED. DIAGNOSTICS, INCLUDING A DYE STUDY, WAS DISCUSSED, HOWEVER HAD NOT BEEN DONE YET. AT REFILLS ON (B)(6) 2012 AND (B)(6) 2013, THEY WERE SURE THE PUMP WAS ACCESSED CORRECTLY AS IT WAS SUPERFICIAL, EASILY ACCESSED, DID NOT MOVE, AND TWO SETS OF HANDS WERE USED TO ENSURE THE NEEDLE STAYED AT THE BACK OF THE NEEDLE STOP THE ENTIRE REFILL. THE 15% INCREASES WERE DONE ON (B)(6) 2012 AND (B)(6) 2013. THE PATIENT CAME IN FOR ADJUSTMENTS MONTHLY LEADING UP TO THE RECENT EVENT WHERE HE EXPERIENCED THE SAME SYMPTOMS. THE DEVICE SYSTEM WAS USED TO DELIVER DILAUDID (HYDROMORPHONE), LIORESAL (BACLOFEN) AND CLONIDINE.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED FROM A HCP (HEALTHCARE PROVIDER) STATED THAT THE NEEDLE MARKS NOTED DURING MANUFACTURER ANALYSIS, THE MARKS WERE FROM AN ATTEMPT TO PERFORM A DYE STUDY. THE PHYSICIAN WAS STILL NOT SURE WHY THE OVERDOSE OCCURRED.

Description of Event or Problem · 1

ADDITIONAL REVIEW REPORTED THAT CONCENTRATION OF CLONIDINE WAS INCREASED FROM 200 UG/ML TO 400 UG/ML DURING THE REFILL ON (B)(6) 2013 BUT A BRIDGE BOLUS WAS NOT PERFORMED. TELEMETRY STRIP OF THE PUMP ALSO SHOWED A MOTOR STALL AND A MOTOR STALL RECOVERY OCCURRED ON (B)(6) 2013.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
38594 SYNCHROMED II PUMP, INFUSION, IMPLANTED, PROGRAMMABLE LKK MDT PUERTO RICO OPERATIONS CO 8637-40

Patients

Seq Age Sex Outcome Treatment
1 00042 YR Hospitalization| L| R