FDA Adverse Event Malfunction Summary report: N

STRATA II VALVE, REGULAR

MDR report key: 3200469 · Received July 1, 2013

Report

Report Number
2021898-2013-00220
Event Type
Malfunction
Date Received
July 1, 2013
Date of Event
June 3, 2013
Report Date
June 3, 2013
Manufacturer
MEDTRONIC NEUROSURGERY
Product Code
JXG
PMA / PMN Number
K042465
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MY
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED TO MEDTRONIC NEUROSURGERY THAT THE VALVE WAS FOUND TO HAVE MALFUNCTIONED PRIOR TO IMPLANTATION WHEN THE PHYSICIAN CHECKED IT WITH A MANOMETER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
299263 STRATA II VALVE, REGULAR SHUNT, CENTRAL NERVOUS SYSTEM AND COMPONENTS JXG MEDTRONIC NEUROSURGERY D11691

Patients

Seq Age Sex Outcome Treatment
1