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