FDA Adverse Event Other Summary report: N

NEUROFLEX

MDR report key: 1278336 · Received December 23, 2008

Report

Report Number
2249852-2008-00003
Event Type
Other
Date Received
December 23, 2008
Date of Event
September 2, 2008
Report Date
December 15, 2008
Manufacturer
COLLAGEN MATRIX, INC.
Product Code
JXI
PMA / PMN Number
K012814
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

SURGEON NOTICED A TRANSVERSE DISRUPTION NEAR THE PROXIMAL ATTACHMENT POINT OF A NERVE. SMALL PORTION OF CONDUIT WAS EXTRACTED, AND THE NERVE WAS REATTACHED TO THE REMAINING PRODUCT. MULTIPLE IRRIGATION AND DEBRIDEMENT PROCEDURES WERE PERFORMED BETWEEN INITIAL IMPLANT AND WHEN ISSUE WAS NOTED ON 9/2.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEUROFLEX COLLAGEN NERVE CONDUIT JXI COLLAGEN MATRIX, INC. CNCF5025 0703182032

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention MULTIPLE IRRIGATION AND DEBRIDEMENT