FDA Adverse Event Death Summary report: N

SYNCHROMED EL

MDR report key: 409687 · Received August 8, 2002

Report

Report Number
2182207-2002-00557
Event Type
Death
Date Received
August 8, 2002
Date of Event
July 15, 2002
Manufacturer
MEDTRONIC INC.
Product Code
LKK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

HCP REPORTED PT SEIZURES AND RESPIRATORY ARREST, REQUIRING INTUBATION, AFTER A REFILL OF 50 MG/ML OF MORPHINE. THE HCP ADMINISTERED TWO BOLUSES OF MARCAINE 7.5 MG EACH THROUGH THE CATHETER ACCESS PORT. THE PT EXPERIENCED PAIN IN LEG IMMEDIATELY AFTER REFILL. THE PT ALSO RECEIVED FENTANYL 600 MCG IV AND VERSED 2 MG IV FOR LEG PAIN. 17-18 CC WERE REMOVED FROM THE PUMP RESERVOIR. THE PT DIED IN THE HOSP ON 7/2002, 12-14 HOURS AFTER THE REFILL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED EL IMPLANTABLE INFUSION PUMP LKK MEDTRONIC INC. 862718 NA

Patients

Seq Age Sex Outcome Treatment
1 57 YR Death CATHETER: MODEL 8703, LOT#J94137423,| EXPLANTED: UNK.| IMLANTED: 1994,