FDA Adverse Event Injury Summary report: N

STRATA VALVE/SHUNT

MDR report key: 2111710 · Received May 25, 2011

Report

Report Number
2021898-2011-00106
Event Type
Injury
Date Received
May 25, 2011
Date of Event
February 24, 2011
Report Date
April 18, 2011
Manufacturer
MEDTRONIC NEUROSURGERY
Product Code
JXG
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS UNAVAILABLE FOR RETURN. THEREFORE, AN EVALUATION OF THE DEVICE PERFORMANCE WAS NOT POSSIBLE. A REVIEW OF THE MANUFACTURING RECORDS WAS NOT POSSIBLE AS NO LOT NUMBER WAS PROVIDED. ALL OF OUR VALVES ARE 100% TESTED AT THE TIME OF MANUFACTURE.

Description of Event or Problem · 1

IT WAS REPORTED TO MEDTRONIC NEUROSURGERY THAT AN (B)(6) PT HAD A SHUNT REVISION. ACCORDING TO THE REPORT, THE STRATA SHUNT WAS NOT DRAINING PROPERLY. THE VALVE WAS EXPLANTED AND REPLACED WITH A CONTOUR VALVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STRATA VALVE/SHUNT JXG MEDTRONIC NEUROSURGERY UNK

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R