FDA Adverse Event
Malfunction
Summary report: N
AUGMENT INJECTABLE
MDR report key: 12516746
·
Received September 22, 2021
Report
- Report Number
- 3003897776-2021-00005
- Event Type
- Malfunction
- Date Received
- September 22, 2021
- Date of Event
- April 28, 2021
- Report Date
- September 22, 2021
- Manufacturer
- BIOMIMETIC THERAPEUTICS, LLC
- Product Code
- NOX
- UDI-DI
- 10859477002140
- PMA / PMN Number
- P100006
- Removal / Correction Number
- Z-2335-2021
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
THE REPORTED EVENT COULD BE CONFIRMED, SINCE INSPECTION OF OTHER LOTS ON THE SHELF WERE FOUND WITH THE SAME ISSUE. BASED ON INVESTIGATION, THE ROOT CAUSE WAS ATTRIBUTED TO A CO-MINGLING RELATED ISSUE. THE FAILURE WAS CAUSED BY TWO PARTIAL VIAL LOT BOXES (1.5ML AND 3.0ML) WERE CONSOLIDATED INTO ONE BOX. A NON-CONFORMANCE WAS OPENED IN THE LEGACY WRIGHT NCE SYSTEM AND A FIELD ACTION ASSESSMENT WAS PERFORMED.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE KIT HAD 1.5CC RHPDGF VIAL INSTEAD OF THE 3CC RHPDGF VIAL. THE KIT WAS MIXED AND COMBINED WITH A SECOND UNIT. NO IMPACT TO PATIENT, JUST LESS PRODUCT USED THAN PLANNED. NO DELAY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1413043 | AUGMENT INJECTABLE | FILLER, BONE VOID, SYNTHETIC PEPTIDE | NOX | BIOMIMETIC THERAPEUTICS, LLC | K30003010 | 1706343 | 10859477002140 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |