FDA Adverse Event Other Summary report: N

SOPHY ADJUSTABLE PRESSURE VALVE SHUNT

MDR report key: 519314 · Received April 2, 2004

Report

Report Number
3001587388-2004-00004
Event Type
Other
Date Received
April 2, 2004
Report Date
April 2, 2004
Manufacturer
SOPHYSA SA
Product Code
JXG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IMPLANTATION OF A SOPHYSA SHUNT FOR HYDROCEPHALUS TREATMENT IN 2003. TWO WEEKS LATER, PATIENT GOT FEVER AND 2 MONTHS LATER, A REVISION WAS OPERATED. INFECTION WAS LOCALIZED ON THE PERITONEAL CATHETER AND CONFIRMED BY THE HOSPTIAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOPHY ADJUSTABLE PRESSURE VALVE SHUNT SHUNT, CENTRAL NERVOUS SYSTEM & COMPONENTS JXG SOPHYSA SA * N0195

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other BO19-10 VENTRICULAR CATHETER.| SM8B SOPHY ADJUSTABLE PRESSURE VALVE