BEUDAMED
    FDA Adverse Event Death Summary report: N

    STRYKER PAINPUMP

    MDR report key: 522822 · Received April 27, 2004

    Report

    Report Number
    1811755-2004-00023
    Event Type
    Death
    Date Received
    April 27, 2004
    Date of Event
    November 6, 2002
    Report Date
    March 29, 2004
    Manufacturer
    STRYKER INSTRUMENTS
    Product Code
    MEB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AL, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    PLANTIFF'S ATTORNEY REPORTED AN INCIDENT WHICH OCCURRED OVER A YEAR AGO. THE REPORT ALLEGES THE PT HAD A PAINPUMP PLACED FOLLOWING A TOTAL SHOULDER ARTHROPLASTY. THE PT WENT INTO VENTRICULAR TACHYCARDIA A 1/2 HOUR AFTER THE PUMP WAS PLACED. A CODE WAS CALLED AND CPR WAS INITIATED. THE PT COULD NOT BE RESUSCITATED AND WAS PRONOUNCED DEAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STRYKER PAINPUMP INFUSION PUMP MEB STRYKER INSTRUMENTS 0500-120-000 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Death