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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 Codes Device Alarm System (1012); Insufficient Device Problem Information (3190)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/19/2025
Type of Reportable Event Malfunction
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.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
Information was received from a consumer regarding a patient receiving dilaudid via an implanted pump.The indication for pump use was non-malignant pain.The patient¿s representative reported that the pump had been beeping every 15-30 minutes.The caller stated that they went to the doctor to get the pump filled and thought the pump was beeping because they were at the end of their medication, but the pump was still beeping after the refill.The caller stated that the patient had a ptm (personal therapy manager) but didn¿t use it because it didn't help them.The agent reviewed considerations and redirected the caller and patient to their healthcare provider to further address the issue.
 
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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 Key23276610
Report Number3004209178-2025-17239
Device Sequence Number8809721
Product Code LKK
UDI-Device Identifier00643169530119
UDI-Public(01)00643169530119(17)190414
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P860004
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2018
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Remedial Action Notification,Recall
Type of Report Initial
Report Date (Section B) 10/13/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date04/14/2019
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 09/26/2025
Initial Report FDA Received Date10/15/2025
Date Device Manufactured10/18/2017
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
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
2182207-11-22-2024-006-C
Patient Sequence Number1
Patient Age60 YR
Patient SexMale
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