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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 Codes Break (1069); Fluid/Blood Leak (1250); Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/12/2025
Type of Reportable Event Malfunction
Event or Problem Description
Medtronic received information regarding an external drainage and monitoring system.It was reported during use of the reported product, a rupture occurred at the connection of the tube wall, resulting in leakage.The product was replaced with a new one.The patient's status at the time of the report was alive-no injury.
 
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.
 
Additional Manufacturer Narrative
H3.Product analysis determined that the visual and optical inspection revealed cracks on one of the stop cock connectors.Functional inspection confirmed the connector leaked at the crack when tested.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.
 
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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 Key23542537
Report Number9617601-2025-02702
Device Sequence Number21194429
Product Code GWM
UDI-Device Identifier00763000333690
UDI-Public(01)00763000333690(17)290310(10)228643682
Combination Product (Y/N)N
Initial Reporter CountryCH
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,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/27/2026
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 Number228643682
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/12/2025
Supplement Date Received by Manufacturer02/26/2026
Initial Report FDA Received Date11/13/2025
Supplement Report FDA Received Date02/27/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/10/2024
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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