FDA Adverse Event Malfunction Summary report: N

VCL+ VIO 36IN 0 S/A CT

MDR report key: 14162048 · Received April 20, 2022

Report

Report Number
2210968-2022-02797
Event Type
Malfunction
Date Received
April 20, 2022
Date of Event
March 18, 2022
Report Date
April 20, 2022
Manufacturer
ETHICON INC.
Product Code
GAM
UDI-DI
10705031052710
PMA / PMN Number
K132580
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

(B)(4). TO DATE THE DEVICE HAS NOT BEEN RETURNED. IF THE DEVICE OR FURTHER DETAILS ARE RECEIVED AT A LATER DATE A SUPPLEMENTAL MEDWATCH WILL BE SENT. A MANUFACTURING RECORD EVALUATION WAS PERFORMED FOR THE FINISHED DEVICE LOT, AND NO NON-CONFORMANCES WERE IDENTIFIED. THIS IS A COMBINATION PRODUCT, AND THE EVENT HAS BEEN REVIEWED FOR BOTH THE SUTURE AND THE TRICLOSAN. TRADE NAME - IRGACARE®, ACTIVE INGREDIENT(S) ¿ TRICLOSAN, DOSAGE FORM ¿ SUTURE/SOLID/PARENTERAL, STRENGTH ¿ = 275 G/M . IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT UNDERWENT A C-SECTION PROCEDURE ON (B)(6) 2022 AND SUTURE WAS USED. THE SUTURE PULLED OFF THE NEEDLE WHEN KNOTTING TO SEW THE UTERUS DURING THE SURGERY. NO ADVERSE PATIENT CONSEQUENCES WERE REPORTED. ADDITIONAL INFORMATION WAS REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1272654 VCL+ VIO 36IN 0 S/A CT SUTURE, ABSORBABLE, SYNTHETIC GAM ETHICON INC. VCP358H RM2AEU 10705031052710

Patients

Seq Age Sex Outcome Treatment
1 31 YR Female