FDA Adverse Event Malfunction Summary report: N

KINETRA

MDR report key: 3915536 · Received July 7, 2014

Report

Report Number
3004209178-2014-12571
Event Type
Malfunction
Date Received
July 7, 2014
Report Date
June 16, 2014
Manufacturer
MEDTRONIC MED REL MEDTRONIC PUERTO RICO
Product Code
MHY
PMA / PMN Number
P960009
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCOMITANT PRODUCTS: PRODUCT ID 3389S-40, LOT # V126057, IMPLANTED: (B)(6) 2008, PRODUCT TYPE LEAD; PRODUCT ID 3389S-40, LOT # V091844, IMPLANTED: (B)(6) 2008, PRODUCT TYPE LEAD; PRODUCT ID 7482A95, SERIAL # (B)(4), IMPLANTED: (B)(6) 2008, PRODUCT TYPE EXTENSION; PRODUCT ID 7482A95, SERIAL # (B)(4), IMPLANTED: (B)(6) 2008, PRODUCT TYPE EXTENSION; PRODUCT ID 7436 , SERIAL# (B)(4), PRODUCT TYPE PROGRAMMER, PATIENT.

Additional Manufacturer Narrative · 1

CONCOMITANT PRODUCTS: PRODUCT ID 3389S-40, LOT# V126057, IMPLANTED: (B)(6) 2008, PRODUCT TYPE LEAD; PRODUCT ID 3389S-40, LOT# V091844, IMPLANTED: (B)(6) 2008, PRODUCT TYPE LEAD; PRODUCT ID 7482A95, SERIAL# (B)(4), IMPLANTED: (B)(6) 2008, PRODUCT TYPE EXTENSION; PRODUCT ID 7482A95, SERIAL# (B)(4), IMPLANTED: (B)(6) 2008, PRODUCT TYPE EXTENSION; PRODUCT ID 7436, SERIAL# (B)(4), PRODUCT TYPE PROGRAMMER, PATIENT. (B)(4)

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED REPORTED THAT THE PATIENT WAS STILL HAVING CONCERNS WITH THEIR DEVICE OR THERAPY BUT WAS WORKING WITH THEIR HEALTHCARE PROFESSIONAL OR MANUFACTURING REPRESENTATIVE. THE PATIENT HAD HAD AN APPOINTMENT ON (B)(6) 2014 AND HAD ONE SCHEDULED FOR (B)(6) 2015. IT WAS NOTED THAT THE PATIENT WAS FUNCTIONING QUITE WELL WITH THEIR NEUROSTIMULATOR BUT HAD VIOLENT TREMORS IN ALL FOUR EXTREMITIES WHEN THE SYSTEM IS OFF. THE PATIENT¿S TREMORS HAD BEEN LESS SEVERE IN 2010 WHEN THE SYSTEM WAS INADVERTENTLY TURNED OFF IN THE AIRPORT SO THEY WERE ABLE TO TALK THE PARAMEDICS THROUGH SYSTEM RE-START.

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED REPORTED THE PATIENT WAS STILL HAVING CONCERNS WITH THEIR DEVICE OR THERAPY BUT WAS WORKING WITH THEIR MANUFACTURING REPRESENTATIVE OR HEALTHCARE PROFESSIONAL. THERE WAS AN APPOINTMENT ON (B)(6). THE PATIENT WAS WORKING WITH THEIR DOCTOR BUT THERE WAS NO SOLUTION IN SIGHT. THE PATIENT HAD HAD DEEP BRAIN STIMULATOR SURGERY IN 2008 AND SINCE TREMORS HAD DEGENERATED TO AN UNCONTROLLABLE DEGREE IN ALL 4 LIMBS WITH THE NEUROSTIMULATOR SYSTEM SHUT OFF. THE EVENT HAD OCCURRED ONCE IN THE AIRPORT DUE TO A STRAY SIGNAL AND PATIENT WAS ABLE TO RE-START THERE WITH THE HELP OF PARAMEDICS. ADDITIONAL REVIEW OF THE EVENT INDICATED THAT  WAS REPORTED THAT THE DEVICE WAS TURNED OFF AND THE PATIENT WAS UNABLE TO TURN THE IMPLANTABLE NEUROSTIMULATOR (INS) BACK ON DUE TO TREMORS. THERAPY DID WORK WHEN IT WAS TURNED ON.WAS NOT APPLICABLE TO THE REPORTED EVENT AND IS BEING CAPTURED IN A SEPARATE EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS TURNED OFF AND THE PATIENT WAS UNABLE TO TURN THE IMPLANTABLE NEUROSTIMULATOR (INS) BACK ON DUE TO TREMORS. THERAPY DID WORK WHEN IT WAS TURNED ON. 4 YEARS PRIOR TO THE DATE OF THIS REPORT THE PATIENT¿S INS THERAPY TURNED OFF IN THE AIRPORT. TREMORS WERE NOT AS BAD AT THAT TIME AND HE WAS ABLE TO TURN THE INS BACK ON. THE PATIENT HAD BEEN SURROUNDED BY PARAMEDICS AND CHANGED THE PATIENT PROGRAMMER BATTERIES AND TURNED THERAPY ON. IT WAS NOTED THAT THE PATIENT LIVED IN FEAR EVERY DAY THAT THE INS WOULD TURN OFF AND HE WOULD NOT BE ABLE TO TURN IT BACK ON. ADDITIONAL INFORMATION WAS REQUESTED BUT HAD NOT BEEN RECEIVED AS OF THE DATE OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
393457 KINETRA STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR MHY MEDTRONIC MED REL MEDTRONIC PUERTO RICO 7428

Patients

Seq Age Sex Outcome Treatment
1 00065 YR