FDA Adverse Event Injury Summary report: N

BIOGLIDE® PERITONEAL CATHETER 8 SLITS

MDR report key: 3250395 · Received July 26, 2013

Report

Report Number
2021898-2013-00255
Event Type
Injury
Date Received
July 26, 2013
Date of Event
June 24, 2013
Report Date
June 27, 2013
Manufacturer
MEDTRONIC NEUROSURGERY
Product Code
JXG
PMA / PMN Number
K951258
Adverse Event
Yes
Product Problem
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 A PERITONEAL CATHETER WAS REVISED BECAUSE IT HAD "RUPTURED." THE CATHETER WAS REPORTED TO HAVE BEEN IMPLANTED SEVERAL YEARS AGO. IT WAS ALSO REPORTED THAT THE PATIENT DID NOT "SHOW ANY SIGNS OF HEALTH HAZARD" RELATED TO THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
349594 BIOGLIDE® PERITONEAL CATHETER 8 SLITS SHUNT, CENTRAL NERVOUS SYSTEM AND COMPONENTS JXG MEDTRONIC NEUROSURGERY UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1