FDA Adverse Event Injury Summary report: N

STRATA 2 VALVE, SMALL, BIOGLIDE

MDR report key: 3250069 · Received July 26, 2013

Report

Report Number
2021898-2013-00251
Event Type
Injury
Date Received
July 26, 2013
Date of Event
June 26, 2013
Report Date
June 26, 2013
Manufacturer
MEDTRONIC NEUROSURGERY
Product Code
JXG
PMA / PMN Number
K042465
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
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.

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 EXPLANTED AS IT COULD NOT BE ADJUSTED. ACCORDING TO THE REPORT, THE PHYSICIAN TRIED TO CHANGE THE PRESSURE SETTING, HOWEVER, WAS UNABLE TO DO SO DUE TO OCCLUSION WITHIN THE VALVE. THE REPORT STATED THAT THE PATIENT DID NOT SHOW ANY SYMPTOMS, HOWEVER, THE PHYSICIAN DECIDED TO EXPLANT THE VALVE AND REPLACE IT WITH A CODMAN HAKIM VALVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
349883 STRATA 2 VALVE, SMALL, BIOGLIDE SHUNT, CENTRAL NERVOUS SYSTEM AND COMPONENTS JXG MEDTRONIC NEUROSURGERY UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 00008 YR Hospitalization| R