BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SYNCHROMED II

    MDR report key: 670284 · Received January 27, 2006

    Report

    Report Number
    2182207-2006-00124
    Event Type
    Injury
    Date Received
    January 27, 2006
    Date of Event
    December 16, 2005
    Report Date
    January 23, 2006
    Manufacturer
    NEUROLOGICAL DIV, MEDTRONIC, INC.
    Product Code
    LKK
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MT, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PER FACILITY, THE PT WAS DISCHARGED TO HOME IN 12/2005.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SYNCHROMED II PUMP LKK NEUROLOGICAL DIV, MEDTRONIC, INC. 863740 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization