• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

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

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

MEDTRONIC PUERTO RICO OPERATIONS CO. SYNCHROMED II; PUMP, INFUSION, IMPLANTED, PROGRAMMABLE Back to Search Results
Model Number 8637-20
Device Problem Insufficient Flow or Under Infusion (2182)
Patient Problems Nausea (1970); Pain (1994); Cramp(s) (2193); Therapeutic Response, Decreased (2271)
Event Date 02/07/2020
Event Type  Injury  
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
The product was returned for analysis.The patient was not in a clinical study, the device was used with/in the patient for treatment, there was no patient death, and the patient recovered without sequela.It was reported that there was no patient injury.A dye study had been performed.The reason for the device removal was ¿refill amount off.¿ the loss of therapy was noted as ¿gradual.¿.
 
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
Information was received from a healthcare provider (hcp) via a manufacturer representative on (b)(6) 2020 regarding a patient receiving morphine (15mg concentration at 2.930mg/day) via an implanted infusion pump.It was reported that when the patient's refill nurse was refilling the pump, they noted an expected volume of 5cc but 10.5cc were withdrawn.The patient had withdrawal symptoms including nausea, cramping, and return of pain.Magnetic resonance imaging (mri) was performed and the catheter was not seen.Computerized tomography (ct) scan showed the catheter at t9.An intraoperative catheter dye study was completed with positive return of cerebrospinal fluid (csf) and dye was noted intrathecally (it).The pump was replaced and the issue was considered resolved.The patient met with the physician on (b)(6) 2020 and the reports were received at that time.There were no noted environmental, external, or patient factors that may have led or contributed to the issue.The patient's status at the time of report was alive - no injury and no further complications were reported or anticipated.
 
Manufacturer Narrative
Analysis of the pump revealed no anomaly.Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided 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.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
SYNCHROMED II
Type of Device
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
MDR Report Key9738507
MDR Text Key186235421
Report Number3004209178-2020-03797
Device Sequence Number1
Product Code LKK
UDI-Device Identifier00643169630505
UDI-Public00643169630505
Combination Product (y/n)N
PMA/PMN Number
P860004
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Type of Report Initial,Followup,Followup
Report Date 04/17/2020
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
Device Operator Health Professional
Device Expiration Date11/14/2020
Device Model Number8637-20
Device Catalogue Number8637-20
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/06/2020
Initial Date Manufacturer Received 02/07/2020
Initial Date FDA Received02/21/2020
Supplement Dates Manufacturer Received02/21/2020
04/16/2020
Supplement Dates FDA Received03/13/2020
04/17/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age56 YR
-
-