FDA Adverse Event Injury Summary report: N

SYNCHROMED II

MDR report key: 3943500 · Received July 18, 2014

Report

Report Number
3007566237-2014-02004
Event Type
Injury
Date Received
July 18, 2014
Report Date
June 24, 2014
Manufacturer
MEDTRONIC NEUROMODULATION
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ANALYSIS OF THE PUMP FOUND NO ANOMALY.

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

(B)(4). ANALYSIS RESULTS WERE NOT AVAILABLE AT THE TIME OF THIS REPORT. A FOLLOW-UP REPORT WILL BE SENT WHEN ANALYSIS IS COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THERE WAS A PUMP INFECTION THAT RESULTED IN EXPLANT. PATIENT OUTCOME WAS NOT PROVIDED. THE DRUG DELIVERED IN THE PUMP WAS UNKNOWN. ADDITIONAL INFORMATION HAS BEEN REQUESTED, BUT WAS NOT AVAILABLE FOR THE DATE OF THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
422807 SYNCHROMED II PUMP, INFUSION, IMPLANTED, PROGRAMMABLE LKK MEDTRONIC NEUROMODULATION 8637-40

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention