BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDTRONIC VRV-100

    MDR report key: 272946 · Received April 3, 2000

    Report

    Report Number
    2022036-2000-00010
    Event Type
    Malfunction
    Date Received
    April 3, 2000
    Date of Event
    March 1, 2000
    Report Date
    March 31, 2000
    Manufacturer
    MEDTRONIC CARDIOPULMONARY-ANAHEIM
    Product Code
    MNJ
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    DC, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE HOSP REPORTED THAT THE VACUUM RELIEF VALVE LEAKED DURING USE. THE VACUUM RELIEF VALVE WAS CHANGED OUT WITH NO AFFECT TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDTRONIC VRV-100 VACUUM RELIEF VALVE MNJ MEDTRONIC CARDIOPULMONARY-ANAHEIM 1140333-1 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other