BEUDAMED
    FDA Adverse Event Other Summary report: N

    SYNCHROMED II

    MDR report key: 966074 · Received June 12, 2006

    Report

    Report Number
    966074
    Event Type
    Other
    Date Received
    June 12, 2006
    Date of Event
    May 3, 2006
    Report Date
    May 16, 2006
    Manufacturer
    MEDTRONIC
    Product Code
    LKK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    IN 2006, 12:49 PM (CIG5E8) SYNCHROMED II PROGRAMMABLE PUMP FAILED. IT WAS EXPLANTED FROM PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SYNCHROMED II PROGRAMMABLE PUMP LKK MEDTRONIC 8637-40 *

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Other