inforMED
MalfunctionKPM

SHUNT DENVER ASCITES DOUBLE VALVE

Received Dec 18, 2017 · Event occurred Nov 30, 2017

Report 1625685-2017-00422 · MDR key 7125715

Device

Generic name

Shunt, Peritoneal

Manufacturer

Carefusion, Inc

Catalog number

42-2000

Lot number

UNKNOWN

Product problems

  • Occlusion Within Device

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

(B)(4) INITIAL EMDR SUBMISSION. A FOLLOW UP EMDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION BECOMES AVAILABLE. (B)(4). DEVICE NOT RETURNED, NO LOT NUMBER PROVIDED.

Description of Event or Problem

SYMPTOMATIC PATIENT WITH ASCITES. DENVER SHUNT, INSERTED IN 2017, NOT PUMPING. RADIOLOGIST CONCERNED ABOUT PUMP CHAMBER AND/OR VENOUS CATHETER BEING BLOCKED. ADVISED TO CHECK THAT THE PUMP CHAMBER AND VENOUS CATHETER ARE NOT BLOCKED. REPLACE WITH NEW DENVER SHUNT. DOUBLE-PAK.

Remedial action

  • Other