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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC MEXICO S. DE R.L. DE CV EXACTA¿; DEVICE, MONITORING, INTRACRANIAL PRESSURE

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MEDTRONIC MEXICO S. DE R.L. DE CV EXACTA¿; DEVICE, MONITORING, INTRACRANIAL PRESSURE Back to Search Results
Model Number 46700
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/05/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
Medtronic received information regarding an external drainage and monitoring system.It was reported that the user worried that this was a problem lot with the system as it had leakage before.No patient involvement.
 
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Brand Name
EXACTA¿
Common Device Name
DEVICE, MONITORING, INTRACRANIAL PRESSURE
Manufacturer (Section D)
MEDTRONIC MEXICO S. DE R.L. DE CV
av. paseo del cucapah #10510
tijuana,bc 22210
MX  22210
Manufacturer (Section G)
MEDTRONIC MEXICO S. DE R.L. DE CV
av. paseo del cucapah #10510
tijuana,bc 22210
MX   22210
Manufacturer Contact
justin ellis
4620 n. beach st.
fort worth, TX 76137
7635265677
MDR Report Key22977947
Report Number9617601-2025-01332
Device Sequence Number9709008
Product Code GWM
UDI-Device Identifier00763000333690
UDI-Public(01)00763000333690(17)290514(10)229010946
Combination Product (Y/N)N
Initial Reporter CountryHK
PMA/510(K) Number
K983799
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/05/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number46700
Device Catalogue Number46700
Device Lot Number229010946
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/05/2025
Initial Report FDA Received Date09/05/2025
Date Device Manufactured06/14/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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