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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC PUERTO RICO OPERATIONS CO. SYNCHROMED II; PUMP, INFUSION, IMPLANTED, PROGRAMMABLE

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MEDTRONIC PUERTO RICO OPERATIONS CO. SYNCHROMED II; PUMP, INFUSION, IMPLANTED, PROGRAMMABLE Back to Search Results
Model Number 8637-20
Medical Device Problem Code Insufficient Device Problem Information (3190)
Health Effect - Clinical Code Spinal Cord Injury (2432)
Date of Event 06/24/2025
Type of Reportable Event Serious Injury
Event or Problem Description
Information was received from a friend/family member regarding a patient who was receiving morphine drug and bupivacaine via an implantable pump for non-malignant pain indications for use.It was reported that the pump was causing damage to the patient's spinal cord.The patient representative (rep) stated that the patient was no longer using the pump, and they were trying to find a physician to take the pump out.The pump has not been in use for a few years.The rep inquired about a recall in 2019.The agent sent physician listings to the rep.The patient had morhpine 6.0 mg in the pump.
 
Additional Manufacturer Narrative
Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
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Brand Name
SYNCHROMED II
Common Device Name
PUMP, INFUSION, IMPLANTED, PROGRAMMABLE
Manufacturer (Section D)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer (Section G)
MEDTRONIC PUERTO RICO OPERATIONS CO.
road 31, km. 24, hm 4
ceiba norte industrial park
juncos PR 00777
Manufacturer Contact
justin ellis
8200 coral sea street ne mvs21
mounds view, MN 55112
7635265677
MDR Report Key22693293
Report Number3004209178-2025-13097
Device Sequence Number12825814
Product Code LKK
UDI-Device Identifier00643169530119
UDI-Public(01)00643169530119(17)190214
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P860004
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2017
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 08/01/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date02/14/2019
Device Model Number8637-20
Device Catalogue Number8637-20
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/15/2025
Initial Report FDA Received Date08/01/2025
Date Device Manufactured08/21/2017
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age42 YR
Patient SexFemale
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