FDA Adverse Event Injury Summary report: N

KINETRA

MDR report key: 4255110 · Received November 17, 2014

Report

Report Number
3004209178-2014-21628
Event Type
Injury
Date Received
November 17, 2014
Report Date
October 27, 2014
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
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCOMITANT PRODUCTS: PRODUCT ID 3387-40, LOT # V002332, IMPLANTED: (B)(6) 2006, PRODUCT TYPE LEAD; PRODUCT ID 3387-40, LOT # V002332, IMPLANTED: (B)(6) 2006, PRODUCT TYPE LEAD; PRODUCT ID 37642, SERIAL # (B)(4), PRODUCT TYPE PROGRAMMER, PATIENT; PRODUCT ID 748251, SERIAL # (B)(4), IMPLANTED: (B)(6) 2006, PRODUCT TYPE EXTENSION; PRODUCT ID 748251, SERIAL # (B)(4), IMPLANTED: (B)(6) 2006, PRODUCT TYPE EXTENSION. (B)(4).

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED REPORTED THE PATIENT WAS STILL HAVING CONCERNS REGARDING THEIR DEVICE OR THERAPY, BUT THEY WERE WORKING WITH THEIR HEALTHCARE PROFESSIONAL (HCP) OR A MANUFACTURING REPRESENTATIVE. THE PATIENT HAD AN APPOINTMENT ON (B)(6) 2014.

Description of Event or Problem · 1

IT WAS THE PATIENT¿S BATTERY WAS REPLACED BECAUSE THE BATTERY DIED; IT WAS UNCLEAR IF IT WAS NORMAL BATTERY DEPLETION. TO THE PATIENT LONGEVITY HAD SEEMED TOO SHORT FROM WHAT HE HAD BEEN TOLD INITIALLY. THE PATIENT HAD DYSTONIA AND HAD TO WAIT 6-8 WEEKS IF HE NEEDED A BATTERY REPLACEMENT. NO OUTCOME WAS PROVIDED. FURTHER FOLLOW-UP IS BEING CONDUCTED TO OBTAIN THIS INFORMATION. IF ADDITIONAL INFORMATION IS RECEIVED A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
742821 KINETRA STIMULATOR, ELECTRICAL, IMPLANTED, FOR PARKINSONIAN TREMOR MRU MEDTRONIC MED REL MEDTRONIC PUERTO RICO 7428

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention