BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 36520 · Received September 4, 1996

    Report

    Report Number
    9612007-1996-00001
    Event Type
    Injury
    Date Received
    September 4, 1996
    Date of Event
    August 5, 1996
    Manufacturer
    *
    Product Code
    JXG
    Report Source
    Manufacturer report
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    PT IS A 33 Y/O FEMALE WHO WAS ORIGINALLY ADMITTED ON 6/4/96 FOR PLACEMENT OF H-V LUMBAR VALVE FOR LUMBAR-PERITONEAL SHUNTING. PT LATER DEVELOPED HEADACHES AND DIZZINESS AND DEVICE WAS REMOVED AND REPLACED ON 8/5/96.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * Implant * JXG * * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *