FDA Adverse Event Summary report: N

MEDTRONIC

MDR report key: 512653 · Received January 23, 2004

Report

Report Number
MW4003678
Date Received
January 23, 2004
Date of Event
February 1, 2000
Report Date
October 31, 2003
Manufacturer
MEDTRONIC, INC. / NEUROLOGICAL & SPINAL DIV.
Product Code
LKK
Report Source
Voluntary report
Reporter Location
NY, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

COMPLAINANT ALLEGES THAT MANUFACTURER HAS NOT PROPERLY REPORTED INFO REGARDING ADVERSE EVENTS INVOLVING MEDTRONIC'S SYNCHROMED INFUSION DEVICE. COMPLAINANT STATES THEY HAD DEVICE SURGICALLY IMPLANTED IN 2000 TO TREAT INTRACTABLE BACK PAIN. THEY STATED THAT THEY SUFFERED A SERIES OF ADVERSE EVENTS AFTER THEIR PHYSICIAN ORDERED AN UNAPPROVED COMBINATION OF MEDICATIONS TO BE INFUSED VIA THE PUMP. COMPLAINANT BELIEVES MEDTRONIC MAY NOT BE REPORTING ALL ADVERSE EVENTS INVOLVING THE USE OF THIS DEVICE AND IS NOW REPORTING SUCH EVENTS UNDER A FICTITIOUS DEVICE MANUFACTURER KNOWN AS RICE CREEK MANUFACTURING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MEDTRONIC SYNCHROMED LKK MEDTRONIC, INC. / NEUROLOGICAL & SPINAL DIV. * NGF005723R

Patients

Seq Age Sex Outcome Treatment
1 *