FDA Adverse Event Injury Summary report: N

REALIZE ADJ GASTRIC BAND STR

MDR report key: 1211152 · Received October 24, 2008

Report

Report Number
3005992282-2008-00199
Event Type
Injury
Date Received
October 24, 2008
Date of Event
August 5, 2008
Report Date
October 20, 2008
Manufacturer
OBTECH MEDICAL SARL
Product Code
LTI
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INFORMATION IS UNAVAILABLE; DEVICE WAS NOT RETURNED FOR EVALUATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT FOLLOWING A LAP GASTRIC BAND PROCEDURE THAT WAS COMPLETED IN 2008, THE PATIENT PRESENTED AT THE HOSPITAL WITH ABDOMINAL PAIN AND SWELLING. ON APPROX ONE AND A HALF MONTHS LATER, A CT SCAN WAS DONE. THERE WAS INFLAMMATION AROUND TUBING IN THE STOMACH. ON SAME DATE, BAND WAS EXPLANTED. PATIENT DISCHARGED HOME WITH HOME HEALTH CARE FOR WOUND VAC CARE. ON THE FOLLOWING MONTH, PATIENT COMPLAINED OF NAUSEA. ON TWENTY SIX DAYS LATER, PATIENT STILL ON WITH HOME HEALTH CARE VISITS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 REALIZE ADJ GASTRIC BAND STR LTI OBTECH MEDICAL SARL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention