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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 Failure to Power Up (1476); Charging Problem (2892); Communication or Transmission Problem (2896); Protective Measures Problem (3015)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/05/2026
Type of Reportable Event Malfunction
Event or Problem Description
Information was received from the patient receiving intrathecal morphine (unknown) via an implantable pump for spinal pain indications.The patient reported that the communicator would not charge and now it was dead.Patient said she uses it every day several times a day and needed it by tomorrow.Agent asked what happens when patient attempts a bolus and patient said they get a message to deliver bolus but could not.Patient also said the charging port was broken and they could not get the cord to go in.Patient tried a new cord and that did not resolve the issue.The issue was not resolved through troubleshooting.A request was sent to the repair department.Patient called back stating they still did not get their new equipment and they had had several hours without pain medicine now.
 
Additional Manufacturer Narrative
Continuation of d10: product id tm90t0, serial# (b)(6), product type accessory section d information references the main component of the system.Other relevant device(s) are: product id: tm90t0, serial/lot #: (b)(6), ubd: 02-apr-2024, udi#: (b)(4), 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
+1(763)526-5677
MDR Report Key50858201
Report Number3004209178-2026-16061
Device Sequence Number21316316
Product Code LKK
UDI-Device Identifier00763000634094
Combination Product (Y/N)N
Initial Reporter StateMO
Initial Reporter CountryUS
PMA/510(K) Number
P860004
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/22/2026
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 Date12/14/2024
Device Model Number8637-20
Device Catalogue Number8637-20
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/10/2026
Initial Report FDA Received Date09/22/2026
Date Device Manufactured06/15/2023
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
Concomitant Medical Products
and Therapy/Usage Dates
"See H11...."
Patient Age64 YR
Patient SexFemale
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