BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDTRONIC NEUROSURGERY LUMBAR DRAIN

    MDR report key: 7214972 · Received January 23, 2018

    Report

    Report Number
    MW5074774
    Event Type
    Malfunction
    Date Received
    January 23, 2018
    Date of Event
    November 7, 2017
    Report Date
    January 9, 2018
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    JXG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS SCHEDULED FOR CRANIOTOMY FOR ANEURYSM CLIPPING. AS PART OF THE SURGICAL PREPARATION, PATIENT WAS HAVING A LUMBAR DRAIN PLACED. PATIENT WAS POSITIONED LATERAL FOR PLACEMENT OF A LUMBAR DRAIN. AFTER A COUPLE ATTEMPTS BY PHYSICIAN, WHEN HE TRIED TO PULL THE CATHETER OUT, THE CATHETER BROKE AND A PIECE WAS LEFT INSIDE THE PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    56155 MEDTRONIC NEUROSURGERY LUMBAR DRAIN LUMBAR DRAIN JXG MEDTRONIC, INC. 213054673

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Other