BEUDAMED
    FDA Adverse Event Other Summary report: N

    PHOENIX DIAMOND II VALVE

    MDR report key: 372605 · Received January 17, 2002

    Report

    Report Number
    2518608-2002-00001
    Event Type
    Other
    Date Received
    January 17, 2002
    Date of Event
    January 9, 2002
    Report Date
    January 17, 2002
    Manufacturer
    PHOENIX BIOMEDICAL CORP.
    Product Code
    JXG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    DE, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    "SHUNT HAD TO BE REMOVED FROM PATIENT DUE TO BLOCKAGE."

    Description of Event or Problem · 1

    "SHUNT HAD TO BE REMOVED FROM PATIENT DUE TO BLOCKAGE."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PHOENIX DIAMOND II VALVE HYDROCEPHALUS SHUNT JXG PHOENIX BIOMEDICAL CORP. * C21

    Patients

    Seq Age Sex Outcome Treatment
    1 5 MO Other