FDA Adverse Event Injury Summary report: N

CODMAN BACTISEAL VENTRICULAR CATHETER

MDR report key: 508628 · Received January 28, 2004

Report

Report Number
1226348-2004-00019
Event Type
Injury
Date Received
January 28, 2004
Report Date
January 7, 2004
Manufacturer
CODMAN & SHURTLEFF, INC./MEDOS S.A.
Product Code
JXG
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

GRAM POSITIVE INFECTION OF STAPH AUREUS WAS ISOLATED FROM A PT THREE DAYS FOLLOWING IMPLANTATION OF A BACTISEAL CATHETER. THE ORGANISM IDENTIFIED AT THE HOSP IN 12/2003 AS A "RARE STRAIN." EXPLANT OF THE DEVICE WAS TO BE SCHEDULED FOR 2004 BUT IT IS NOT KNOWN IF THAT TOOK PLACE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CODMAN BACTISEAL VENTRICULAR CATHETER SHUNT, CENTRAL NERVOUS SYSTEM & COMPONENTS JXG CODMAN & SHURTLEFF, INC./MEDOS S.A. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention