FDA Adverse Event Malfunction Summary report: N

CSF-FLOW CONTROL VALVE, CONTOURED SMALL, HIGH PRESSURE

MDR report key: 3070593 · Received April 17, 2013

Report

Report Number
2021898-2013-00141
Event Type
Malfunction
Date Received
April 17, 2013
Date of Event
March 15, 2013
Report Date
March 18, 2013
Manufacturer
MEDTRONIC NEUROSURGERY
Product Code
JXG
PMA / PMN Number
K841442
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE RETURNED VALVE WAS PATENT AND MET THE REQUIREMENTS FOR LEAK, REFLUX AND PREIMPLANTATION TESTING. HOWEVER, IT DID NOT MEET THE REQUIREMENTS FOR PRESSURE-FLOW TESTING DUE TO PRESENCE OF PROTEINACEOUS DEBRIS WITHIN THE INTERIOR OF THE VALVE. PROTEINACEOUS DEBRIS WITH IN THE VALVE MAY HOLD PRESSURE-FLOW CONTROLLING MECHANISMS OPEN, RESULTING IN FLUID REFLUX AND/OR SIPHONING. A REVIEW OF THE MFG RECORDS SHOWED NO ANOMALIES. 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 THE PRODUCT CATALOG INDICATED THAT THE DEVICE, A HIGH PRESSURE VALVE, SHOULD BE OPERATING AT A PRESSURE RANGE BETWEEN 135 - 155 MM H2O, BUT THAT THE PHYSICIAN FOUND IT TO BE OPERATING AT ABOUT 70 MM H2O. NO ADVERSE IMPACT OR INJURY TO THE PT WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
164868 CSF-FLOW CONTROL VALVE, CONTOURED SMALL, HIGH PRESSURE JXG - SHUNT, CENTRAL NERVOUS SYSTEM AND COMPONENTS JXG MEDTRONIC NEUROSURGERY D34962

Patients

Seq Age Sex Outcome Treatment
1