FDA Adverse Event Malfunction Summary report: N

SOLETRA

MDR report key: 3162931 · Received June 11, 2013

Report

Report Number
3004209178-2013-10158
Event Type
Malfunction
Date Received
June 11, 2013
Report Date
May 21, 2013
Manufacturer
MEDTRONIC MED REL MEDTRONIC PUERTO RICO
Product Code
MRU
PMA / PMN Number
H020007
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

CONCOMITANT PRODUCTS: PRODUCT ID 7426, SERIAL # (B)(4), IMPLANTED: (B)(6) 2011, PRODUCT TYPE IMPLANTABLE NEUROSTIMULATOR; PRODUCT ID 7438, SERIAL # (B)(4), PRODUCT TYPE PROGRAMMER, PATIENT; PRODUCT ID 3387-40, LOT # V007376, IMPLANTED: (B)(6) 2006, PRODUCT TYPE LEAD; PRODUCT ID 748240, SERIAL # (B)(4), IMPLANTED: (B)(6) 2006, PRODUCT TYPE EXTENSION; PRODUCT ID 3387-40, LOT # V007376, IMPLANTED: (B)(6) 2006, PRODUCT TYPE LEAD; PRODUCT ID 748240, SERIAL # (B)(4), IMPLANTED: (B)(6) 2006, PRODUCT TYPE EXTENSION. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT¿S BATTERY ¿ONLY LASTED TWO YEARS AND ONE MONTH WHEN THEIR LAST BATTERY LASTED FOUR AND A HALF YEARS.¿ THE PATIENT HAS BILATERAL BATTERIES AND IT WAS UNCLEAR IF BOTH BATTERIES WERE DEPLETED. IT WAS UNKNOWN IF THE RIGHT SIDE WOULD BE REPLACED. REFERENCE MANUFACTURER REPORT # 3004209178-2013-10156. PATIENT HAD BILATERAL SYSTEMS AND IT WAS UNCLEAR WHETHER BOTH OR ONE SYSTEM HAD DEPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT EXPERIENCED SYMPTOM OF SPASTICITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
262709 SOLETRA STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR MRU MEDTRONIC MED REL MEDTRONIC PUERTO RICO 7426

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention