BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDTRONIC, INC.

    MDR report key: 561970 · Received November 4, 2004

    Report

    Report Number
    MW1033918
    Event Type
    Malfunction
    Date Received
    November 4, 2004
    Date of Event
    October 25, 2004
    Report Date
    November 3, 2004
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    LKK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    SC, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT SAID PUMP WAS DEFECTIVE AND WANTED IT TO BE REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC, INC. MORPHINE PUMP LKK MEDTRONIC, INC. UNK *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other