FDA Adverse Event Other Summary report: N

ELEVESS

MDR report key: 1202892 · Received October 17, 2008

Report

Report Number
1223628-2008-00013
Event Type
Other
Date Received
October 17, 2008
Date of Event
August 30, 2008
Report Date
October 17, 2008
Manufacturer
ANIKA THERAPEUTICS, INC.
Product Code
LMH
PMA / PMN Number
P050033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PATIENT'S CONDITION IS CURRENTLY RESOLVED. THE BATCH RECORD, INCLUDING STERILITY TESTING RECORDS, WAS REVIEWED AND DID NOT REVEAL ANY ISSUES WITH THE ALLEGED PRODUCT LOT.

Description of Event or Problem · 1

SWELLING AND LUMPINESS ALLEGEDLY IN THREE WEEKS AFTER INJECTION AT THE INJECTION AREA. THE PATIENT WAS TREATED WITH FIVE UNITS OF HYALURONIDASE. AN UPDATE WAS RECEIVED THAT NOTED THE PATIENT EXPERIENCED SOME NODULES ERUPTION. THERE WAS NO OTHER MEDICATION ADMINISTERED AND THE PATIENT SYMPTOMS HAVE SINCE RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ELEVESS IMPLANT, DERMAL, FOR AESTHETIC USE LMH ANIKA THERAPEUTICS, INC. V080010AC

Patients

Seq Age Sex Outcome Treatment
1 NK Required Intervention