FDA Adverse Event Injury Summary report: N

INDURA

MDR report key: 992404 · Received February 6, 2008

Report

Report Number
6000030-2008-00558
Event Type
Injury
Date Received
February 6, 2008
Report Date
July 13, 2007
Manufacturer
RICE CREEK MANUFACTURING
Product Code
LKK
PMA / PMN Number
P860004
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING SUBMITTED AS PART OF A RETROSPECTIVE REVIEW OF EVENTS RELATED TO MEDTRONIC NEUROMODULATION OFFICE OF MEDICAL AFFAIRS EVENTS AND HAS BEEN DISCUSSED WITH THE REPORTING SYSTEMS MONITORING BRANCH AT FDA.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT WAS EXPERIENCING "LOWER EXTREMITY SENSORY CHANGES AFTER IMPLANT". SPECIFIC SYMPTOMS WERE NOT REPORTED. ATTEMPTS TO OBTAIN ADD'L INFO WERE UNSUCCESSFUL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INDURA LKK RICE CREEK MANUFACTURING 8709 N096554021

Patients

Seq Age Sex Outcome Treatment
1 YR Other IMPLANTED:| PUMP MODEL #: 8637AA| IMPLANTED:| EXPLANTED:| CATHETER MODEL 8709AA LOT# N096823019| EXPLANTED:| PROGRAMMER MODEL 8840