FDA Adverse Event Other Summary report: N

SYNCHROMED

MDR report key: 610541 · Received June 1, 2005

Report

Report Number
2182207-2005-00845
Event Type
Other
Date Received
June 1, 2005
Report Date
May 24, 2005
Manufacturer
NEUROLOGICAL DIVISION, MEDTRONIC, INC.
Product Code
LKK
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE MANUFACTURER'S REPRESENTATIVE REPORTED THE PATIENT HAD BEEN EXPERIENCING A RETURN OF PAIN. THE FIRST ROLLER STUDY DIDN'T SHOW ANY MOVEMENT. A SECOND ROLLER STUDY WAS DONE THAT SHOWED THE ROLLER DID MOVE. A FOLLOW UP REPORT WILL BE SENT WHEN ADDITIONAL INFORMATION IS RECEIVED.

Description of Event or Problem · 1

IT WAS DETERMINED THAT THE EVENT DESCRIBED IN MANUFACTURER'S REPORT NUMBER 2182207-2005-00845 WAS PREVIOUSLY REPORTED IN MANUFACTURER'S REPORT NUMBER 6000030-2005-00970.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYNCHROMED PUMP LKK NEUROLOGICAL DIVISION, MEDTRONIC, INC. PUMP NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention