FDA Adverse Event Injury Summary report: N

NI

MDR report key: 10465931 · Received August 28, 2020

Report

Report Number
1416980-2020-05261
Event Type
Injury
Date Received
August 28, 2020
Report Date
October 5, 2020
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FTM
PMA / PMN Number
NI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THE DEVICE WAS NOT RETURNED, AND THE LOT NUMBER IS UNKNOWN; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 1

THE REPORTED PRODUCT IS AN UNKNOWN BAXTER PERI-STRIPS PSD-V WITH GEL. THE DEVICE WAS NOT RETURNED, AND THE LOT NUMBER IS UNKNOWN; THEREFORE, A DEVICE. ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED FROM AN ANONYMOUS SURVEY RESULT THAT THE PERCENTAGE OF PATIENTS THAT HAD REOPERATIONS DUE TO STAPLE LINE LEAKS OR STAPLE LINE BLEEDING AFTER USING PERI-STRIPS WITH GEL FOR THE REINFORCEMENT OF STAPLE LINES DURING GASTRIC, INCLUSIVE OF SMALL BOWEL SURGICAL PROCEDURES WAS 1-3%. THE PHYSICIAN REPORTED ¿ABOUT 1/2 OF THOSE WITH LEAKS NEEDED REOP" (NO FURTHER DETAILS). AT THE TIME OF THIS REPORT, NO FURTHER DETAIL WAS PROVIDED REGARDING IF HOSPITALIZATION WAS REQUIRED, TREATMENT FOR THE EVENT OR THE PATIENT¿S OUTCOME. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
929935 NI MESH, SURGICAL FTM BAXTER HEALTHCARE CORPORATION NA NI

Patients

Seq Age Sex Outcome Treatment
1 Other