FDA Adverse Event Injury Summary report: N

PROKERA

MDR report key: 11724001 · Received April 26, 2021

Report

Report Number
3009809074-2021-00003
Event Type
Injury
Date Received
April 26, 2021
Date of Event
March 11, 2021
Report Date
April 23, 2021
Product Code
NQB
PMA / PMN Number
K032104
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

TTI RECEIVED REPORT OF AN PATIENT ADVERSE EVENT FROM SALES REP, (B)(6). THE INITIAL COMMUNICATION STATED THAT THE PATIENT WAS TREATED WITH PROKERA SLIM FOR RECURRENT CORNEAL EROSION. TTI MEDICAL DIRECTOR WAS NOTIFIED OF THIS EVENT ON (B)(6) 2021. THE TREATING PHYSICIAN PERFORMED A DEBRIDEMENT AND PLACED A PKS ON THE EYE, AND PRESCRIBED THE PATIENT OFLOXICIN. THE PATIENT EXPERIENCED CONTINUOUS EYE TEARING AND THE FORMATION OF CYSTS ON THE EYE. THE PATIENT WAS THEN REFERRED TO A CORNEA SPECIALIST WHO SCRAPED THE EYE AND PLACED A BANDAGE CONTACT LENS. THE INITIAL COMMUNICATION STATED THAT THE PATIENT IS WELL AND THE PATIENT SYMPTOMS RESOLVED AFTER PLACEMENT OF THE BANDAGE CONTACT LENS. THE TREATING PHYSICIAN WAS CONTACTED TO PROVIDE ADDITIONAL INFORMATION BUT A RESPONSE HAS NOT YET BEEN RECEIVED. NO PRODUCT DEFECT WAS REPORTED BY THE CUSTOMER. THE FORM INDICATED THE DEVICE WAS DISCARDED BY THE CUSTOMER. THE MANUFACTURING BATCH RECORD FOR ASSOCIATED LOT WAS REVIEWED AND NO NONCONFORMITIES IDENTIFIED. REVIEW OF COMPLAINT RECORDS INDICATE NO OTHER COMPLAINTS HAVE BEEN RECEIVED FOR THE ASSOCIATED LOT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
625505 PROKERA PROKERA SLIM NQB BTR183554

Patients

Seq Age Sex Outcome Treatment
1 Other| R