FDA Adverse Event Malfunction Summary report: N

PICO 7 SINGLE DRSG 15CM X 15CM

MDR report key: 12096101 · Received June 30, 2021

Report

Report Number
8043484-2021-01623
Event Type
Malfunction
Date Received
June 30, 2021
Date of Event
June 14, 2021
Report Date
July 8, 2021
Manufacturer
SMITH & NEPHEW MEDICAL LTD.
Product Code
OMP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

H10. THE INFORMATION RECEIVED BY THE MANUFACTURER HAS BEEN RE-EVALUATED FOR MDR REPORTING AND IT WAS DETERMINED THAT THIS CASE DOES NOT MEET THE THRESHOLD FOR REPORTING AND IS A NON-REPORTABLE EVENT. THE LOSS OF NEGATIVE PRESSURE WOUND THERAPY DUE TO AN INOPERATIVE OR 'STOPPED' PUMP WILL NOT DIRECTLY CAUSE OR CONTRIBUTE TO SERIOUS INJURY OR DEATH AS THE PICO DRESSING CAN REVERT TO MANAGING THE WOUND AS A STANDARD MULTILAYER DRESSING. NO RISK TO PATIENT SAFETY IS ANTICIPATED. THIS EVENT IS CONSIDERED NOT REPORTABLE PURSUANT TO 21 CFR PART 803.

Description of Event or Problem · 1

IT WAS REPORTED THAT, DURING NPW TREATMENT, A PICO 7 SINGLE DRSG 15CM X 15CM WAS VIBRATING WITHOUT MAKING ANY NEGATIVE PRESSURE AND STOPPED WORKING AFTER TWO DAYS. TREATMENT WAS RESUMED, AFTER SIGNIFICANT DELAY, WITH A BACK-UP DEVICE. PATIENT WAS NOT INJURED AS CONSEQUENCE OF THIS PROBLEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
989302 PICO 7 SINGLE DRSG 15CM X 15CM NEGATIVE PRESSURE WOUND THERAPY POWERED SUCTION PUMP OMP SMITH & NEPHEW MEDICAL LTD. UNK

Patients

Seq Age Sex Outcome Treatment
1