PROGAV 2.0 SYS W/SA20 A.CONTROL RESERV. FX434T

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-13 for PROGAV 2.0 SYS W/SA20 A.CONTROL RESERV. FX434T manufactured by Christoph Miethke Gmbh & Co. Kg.

Event Text Entries

[183374017] The product was not returned. Manufacturing and quality control data - without a serial number it is not possible for us to retrace the complained product. Nevertheless, we can ensure that a progav 2. 0 shunt system has a normal pressure range of 0-2c cm h2o. The shunt system was inspected. All parameters are inspected and signed during the manufacturing process. Complaint history - see the complaint history in regards to the article number over the last 3 years: 2017 - 5 total complaints - 2 with similar malfunction. 2018 - 5 total complaints - 0 with similar malfunction. 2019 - 5 total complaints - 1 with similar malfunction. 2020 - 2 total complaints - 2 with similar malfunction. No corrective actions were needed. Result - an investigation was not possible because no product was available. Based on the complaint description it could be possible that any deposits of protein have caused the valve's non-adjustability. As described in scientific literature, the problem encountered is one of the known, inevitable risks of hydrocephalus therapy by shunt implants. However, we cannot fully clarify what influenced the valve condition, as this would require an examination of the valve. No further actions are required.
Patient Sequence No: 1, Text Type: N, H10


[183374018] It was reported that there was an issue with the shunt system. The patient was initially implanted on an unspecified date. Sometime after the implantation, the symptoms of the patient were "not so well" and ventricular enlargement was confirmed. So, the surgeon tried to adjust the pressure to 0cm but it did not improve. After this, the surgeon took out the progav and implanted another company's product instead. The surgeon noted that perhaps the size of the product had not been appropriate to the patient when he chose the product. Also, the surgeon did not try to flash since he had no idea that the product was able to be flashed. There was no blockage found within the catheter that was taken out at the same time as the valve. A revision was performed due to the malfunction. Additional information was not provided. Associated medwatches: 3004721439-2020-00064, 3004721439-2020-00065.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004721439-2020-00064
MDR Report Key9830126
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-13
Date of Report2020-03-13
Date of Event2018-02-25
Date Mfgr Received2020-02-28
Date Added to Maude2020-03-13
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. JOERG KNEBEL
Manufacturer Street2 ULANENWEG
Manufacturer CityPOTSDAM D, 14469
Manufacturer CountryGM
Manufacturer Postal14469
Manufacturer G1CHRISTOPH MIETHKE GMBH & CO. KG
Manufacturer Street2 ULANENWEG
Manufacturer CityPOTSDAM, 14469
Manufacturer CountryGM
Manufacturer Postal Code14469
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePROGAV 2.0 SYS W/SA20 A.CONTROL RESERV.
Generic NameHYDROCEPHALUS MANAGEMENT
Product CodeJXG
Date Received2020-03-13
Model NumberFX434T
Catalog NumberFX434T
Lot Number20034694
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCHRISTOPH MIETHKE GMBH & CO. KG
Manufacturer Address2 ULANENWEG POTSDAM, 14469 GM 14469


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-13

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