FDA Adverse Event Malfunction Summary report: N

SYNCHROMED II

MDR report key: 8805860 · Received July 19, 2019

Report

Report Number
3004209178-2019-13851
Event Type
Malfunction
Date Received
July 19, 2019
Report Date
July 30, 2019
Manufacturer
MEDTRONIC PUERTO RICO OPERATIONS CO.
Product Code
LKK
UDI-DI
00643169100831
PMA / PMN Number
P860004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

INFORMATION WAS RECEIVED FROM A CONSUMER (FRIEND / FAMILY MEMBER OF PATIENT) REGARDING A PATIENT WHO WAS RECEIVING AN UNSPECIFIED DRUG OF UNSPECIFIED CONCENTRATION AT AN UNSPECIFIED DOSE RATE VIA AN IMPLANTABLE PUMP FOR NON-MALIGNANT PAIN. IT WAS REPORTED THE PATIENT¿S PUMP WAS EMPTY DUE TO NOT BEING ABLE TO FIND A DOCTOR TO FILL HER PUMP. THE DATE OF THE EVENT WAS NOT SPECIFIED. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WAS RECEIVED FROM A PATIENT. IT WAS REPORTED THAT PATIENT WAS HEARING A MULT-TONE ALARM, HOWEVER PATIENT DID NOT HAVE MEDICATION IN PUMP FOR TWO YEARS, SO IT HAD BEEN RUNNING DRY FOR THIS TIME PERIOD. PUMP HAD BEEN RUNNING DRY FOR TWO YEARS AS PATIENT WAS NOT ABLE TO FIND A NEW MANAGING HCP. PATIENT WAS SCHEDULED FOR A MAGNETIC RESONANCE IMAGING (MRI). NO FURTHER COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
603087 SYNCHROMED II PUMP, INFUSION, IMPLANTED, PROGRAMMABLE LKK MEDTRONIC PUERTO RICO OPERATIONS CO. 8637-20 00643169100831

Patients

Seq Age Sex Outcome Treatment
1