FDA Adverse Event
Malfunction
Summary report: N
DELTA VALVE, SMALL, WITH RIGHT ANGLE CONNECTOR
MDR report key: 1200071
·
Received October 15, 2008
Report
- Report Number
- 2021898-2008-00239
- Event Type
- Malfunction
- Date Received
- October 15, 2008
- Date of Event
- September 16, 2008
- Report Date
- September 16, 2008
- Manufacturer
- MEDTRONIC NEUROSURGERY
- Product Code
- JXG
- PMA / PMN Number
- K902783
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE HAS NOT YET BEEN RETURNED TO THE MANUFACTURER.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE VALVE DID NOT FLOW, IT WAS OCCLUDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | DELTA VALVE, SMALL, WITH RIGHT ANGLE CONNECTOR | 84JXG | JXG | MEDTRONIC NEUROSURGERY | NA | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |