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Visual inspection: during the investigation, a deformation of the outer housing of the progav could be determined.The measurement of the plane parallelism could confirm that with a value of -0,043 mm - outside tolerance (0 ± 0.02 mm).Permeability test: a permeability test has shown that all components are permeable.Computer controlled test: to investigate the claim of under-drainage, the opening pressure is measured using a miethke computer controlled testing apparatus which simulates a cerebrospinal fluid flow.The valves are tested in both the horizontal as well as the vertical positions.The results show that the progav operates within the accepted tolerance in the horizontal position.The shuntassistant does not operate within the specified tolerances in both positions.An accelerated outflow in the vertical position and a slower outflow in the horizontal position of shuntassistant could be determined.Adjustment test: the progav was tested and is adjustable to all specified pressures.Braking force and brake function test: the brake functionality test has shown that the brake function operates as expected and the braking force is within the given tolerances.Internal inspection: after dismantling of the valves, deposits were found in both valves.Results: based on our investigation results, we can determine that there is deformation of the progav housing surface.Excessive pressure with the adjustment tool can lead to deformation of the housing surface.Furthermore, we can detect accelerated outflow in the vertical position and slowed outflow in the horizontal position of the shuntassistant.The deposits visible in the valve led to the change in flow rate.Deposits caused by natural substances found in the body, such as protein, blood, or tissue particles, are among the known and unavoidable risks and side effects of hydrocephalus therapy.Even small amounts of organic deposits can compromise the integrity of the valve.The examination of the return shipment is complete with the preparation of this report.The shunt system met all specifications of the final inspection when released from christoph miethke gmbh & co.Kg.No further regulatory actions are required from our point of view.
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