FDA Adverse Event
Other
Summary report: N
SYNCHROMED EL
MDR report key: 472557
·
Received July 17, 2003
Report
- Report Number
- 6000030-2003-00601
- Event Type
- Other
- Date Received
- July 17, 2003
- Date of Event
- July 8, 2003
- Report Date
- July 11, 2003
- Manufacturer
- RICE CREEK MANUFACTURING
- Product Code
- LKK
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MN, US
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
THE HCP EXPLANTED THE PUMP AND RETURNED IT TO THE MANUFACTURER FOR ANALYSIS. NO REASON FOR THE EXPLANT WAS GIVEN. A FOLLOW UP REPORT WILL BE SENT WHEN ADDITIONAL INFO IS RECEIVED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SYNCHROMED EL | PUMP | LKK | RICE CREEK MANUFACTURING | 862618 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 50 YR | Other | CATHETER: MODEL #8709, LOT# L65391, IMPLANTED:1999| EXPLANTED: UNK. |