FDA Adverse Event Injury Summary report: N

SYNCHROMED II

MDR report key: 3142593 · Received June 3, 2013

Report

Report Number
3004209178-2013-08540
Event Type
Injury
Date Received
June 3, 2013
Report Date
May 13, 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 Location
MN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

PRODUCT ID: 8709, SERIAL# (B)(4), IMPLANTED: (B)(6) 2006, PRODUCT TYPE: CATHETER. PRODUCT ID: 8840, SERIAL# UNKNOWN, PRODUCT TYPE: PROGRAMMER. (B)(4).

Description of Event or Problem · 1

(B)(4): IT WAS REPORTED THAT THE PATIENT EXPERIENCED RETURNED SPASTICITY AND HALLUCINATIONS. THE DOSE WAS READJUSTED BY THE PHYSICIAN AND THE PATIENT WAS REPORTED TO BE ¿DOING FINE NOW¿.

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED REPORTED THAT THE PATIENT PRESENTED A COUPLE DAYS AFTER THE PUMP REPLACEMENT TO THE HEALTH CARE PROVIDER¿S (HCP) OFFICE WITH SYMPTOMS INCLUDING UNDER DOSING, MILD WITHDRAWAL SYMPTOMS AND ITCHING. IT WAS NOTED THE PROGRAMMING ERROR WAS DUE TO HUMAN ERROR AT THE TIME OF THE PUMP REPLACEMENT IN THE OPERATING ROOM. THE PATIENT RECOVERED WITHOUT SEQUELAE.

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT¿S PUMP WAS PROGRAMMED TO 2000 MCG/ML, BUT THE PUMP ACTUALLY HAD 500 MCG/ML IN IT FROM THE DAY IT WAS IMPLANTED. WITHDRAWAL WAS REPORTED, WHICH OCCURRED OVER THE NEXT SEVERAL DAYS AFTER THE PUMP WAS REPLACED. THE PUMP WAS BEING USED TO DELIVER LIORESAL. IT WAS LATER REPORTED THE HEALTHCARE PROVIDER (HCP) PLANNED TO RE-PROGRAM THE PUMP AND INCREASE THE PATIENT¿S DOSE ON THE DATE OF THIS REPORT. THE PATIENT'S STATUS WAS UNDETERMINED AT THE TIME OF THE REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
244647 SYNCHROMED II PUMP, INFUSION, IMPLANTED, PROGRAMMABLE LKK MDT PUERTO RICO OPERATIONS CO 8637-40

Patients

Seq Age Sex Outcome Treatment
1 00043 YR Other