SYNCHROMED II 8637-40

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,foreign,health pr report with the FDA on 2020-03-25 for SYNCHROMED II 8637-40 manufactured by Medtronic Neuromodulation.

Event Text Entries

[186460279] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2182207-2020-00065
MDR Report Key9879199
Report SourceDISTRIBUTOR,FOREIGN,HEALTH PR
Date Received2020-03-25
Date of Report2020-03-30
Date Mfgr Received2020-03-23
Date Added to Maude2020-03-25
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactLISA WOODWARD CLARK
Manufacturer Street7000 CENTRAL AVENUE NE RCW215
Manufacturer CityMINNEAPOLIS MN 55432
Manufacturer CountryUS
Manufacturer Postal55432
Manufacturer Phone7635263920
Manufacturer G1MEDTRONIC NEUROMODULATION
Manufacturer Street7000 CENTRAL AVE NE
Manufacturer CityMINNEAPOLIS MN 55432
Manufacturer CountryUS
Manufacturer Postal Code55432
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSYNCHROMED II
Generic NamePUMP, INFUSION, IMPLANTED, PROGRAMMABLE
Product CodeLKK
Date Received2020-03-25
Model Number8637-40
Catalog Number8637-40
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC NEUROMODULATION
Manufacturer Address7000 CENTRAL AVE NE MINNEAPOLIS MN 55432 US 55432


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-25

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