UNKNOWN EEA
Report
- Report Number
- 2647580-2022-04373
- Event Type
- Injury
- Date Received
- December 1, 2022
- Date of Event
- August 15, 2022
- Report Date
- March 23, 2023
- Manufacturer
- US SURGICAL PUERTO RICO
- Product Code
- GDW
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IT
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
CONCOMITANT MEDICAL PRODUCTS: UNKNOWN GIA UNKNOWN GIA PRODUCT. TITLE: HAND-SEWN VERSUS STAPLED SMALL BOWEL ANASTOMOSES IN PATIENTS WITH SECONDARY MESENTERIC ISCHEMIA SOURCE: JOURNAL OF SURGICAL RESEARCH JANUARY 2023 (281) 52 E5 6 0022-4804/$ E SEE FRONT MATTER ª 2022 ELSEVIER INC. ALL RIGHTS RESERVED. HTTPS://DOI.ORG/10.1016/J.JSS.2022.08.007. MEDTRONIC IS SUBMITTING THIS REPORT TO COMPLY WITH FDA REPORTING REGULATIONS UNDER 21 CFR PARTS 4 AND 803. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION AND HAS PROVIDED AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY ¿DEFECTS¿ OR HAS ¿MALFUNCTIONED¿. THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REGULATORY REPORTING. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE THEM BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT.
MEDTRONIC IS SUBMITTING THIS REPORT TO COMPLY WITH FDA REPORTING REGULATIONS UNDER 21 CFR PARTS 4 AND 803. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION AND HAS PROVIDED AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY ¿DEFECTS¿ OR HAS ¿MALFUNCTIONED¿. THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REGULATORY REPORTING. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE THEM BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT. A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.
ACCORDING TO THE LITERATURE, A RETROSPECTIVE STUDY COMPARED HAND-SEWN INTESTINAL ANASTOMOSES WITH STAPLED ANASTOMOSES IN PATIENTS WHO UNDERWENT SMALL BOWEL RESECTION FOR ACUTE MESENTERIC ISCHEMIA BETWEEN JANUARY 2015 AND JUNE 2021. THE PATIENTS WERE DIVIDED INTO THREE GROUPS: GROUP 1: HAND-SEWN ANASTOMOSIS GROUP WITH A COMPETITOR SUTURE, GROUP 2: STAPLED END-TO-SIDE ANASTOMOSIS WITH CIRCULAR STAPLER ANVIL 25MM AND LINEAR STAPLER 80MM TO CLOSE THE ENDS OF THE SMALL BOWEL, GROUP 3: STAPLED SIDE-TO-SIDE ANASTOMOSIS WITH LINEAR STAPLER 80MM. THERE WERE 137 PATIENTS IN THE STUDY: 48 PATIENTS WERE IN GROUP 1, 56 WERE IN GROUP 2 AND 33 WERE IN GROUP 3. COMPLICATIONS INCLUDED ANASTOMOTIC LEAK, PERITONITIS, SEPSIS, AND HEMORRHAGE. ANASTOMOTIC LEAK WAS TREATED WITH REOPERATION. FIVE PATIENTS REQUIRED RESECTION OF THE ANASTOMOSIS AND TWO PATIENT REQUIRED ILEOSTOMY. HEMORRHAGE WAS SELF-LIMITED AND DID NOT REQUIRE REOPERATION. OTHER COMPLICATIONS NOT RELATED TO THE DEVICE INCLUDED: PULMONARY EMBOLISMS, MYOCARDIAL INFARCTIONS, PULMONARY ATELECTASIS WITH SUPERIMPOSED BACTERIAL PNEUMONIA, SUPERFICIAL WOUND INFECTIONS, AND SUPERFICIAL PHLEBITIS. FOUR DEATHS OCCURRED IN THIS GROUP AND WERE NOT RELATED TO THE DEVICE.
ACCORDING TO THE LITERATURE, A RETROSPECTIVE STUDY COMPARED HAND-SEWN INTESTINAL ANASTOMOSES WITH STAPLED ANASTOMOSES IN PATIENTS WHO UNDERWENT SMALL BOWEL RESECTION FOR ACUTE MESENTERIC ISCHEMIA BETWEEN JANUARY 2015 AND JUNE 2021. THE PATIENTS WERE DIVIDED INTO THREE GROUPS: GROUP 1: HAND-SEWN ANASTOMOSIS GROUP WITH A COMPETITOR SUTURE, GROUP 2: STAPLED END-TO-SIDE ANASTOMOSIS WITH CIRCULAR STAPLER ANVIL 25MM AND LINEAR STAPLER 80MM TO CLOSE THE ENDS OF THE SMALL BOWEL, THERE WERE 137 PATIENTS IN THE STUDY: 48 PATIENTS WERE IN GROUP 1, 56 WERE IN GROUP 2. COMPLICATIONS INCLUDED ANASTOMOTIC LEAK MANAGEMENT, ONE CASE IN GROUP 1 OF CONTAINED DEHISCENCE IN PATIENTS WITHOUT SIGNS OF SEPSIS OR POSTOPERATIVE PERITONITIS AND WERE CONSERVATIVELY TREATED. 3 CASES OF DEHISCENCE IN PATIENTS WITH SIGNS OF SEPSIS AND PERITONITIS AND WERE TREATED WITH RE SURGERY. RE-OPERATED PATIENTS UNDERWENT RESECTION OF THE ANASTOMOSIS FOLLOWED BY RE-ANASTOMOSIS AND ILEOSTOMY. OTHER ANASTOMOTIC COMPLICATION INCLUDED WAS HEMORRHAGE AND IT WAS A SELF-LIMITED AND DID NOT REQUIRED OPERATION. OTHER COMPLICATIONS NOT RELATED TO THE DEVICE INCLUDED: PULMONARY EMBOLISMS, MYOCARDIAL INFARCTIONS, PULMONARY ATELECTASIS WITH SUPERIMPOSED BACTERIAL PNEUMONIA, SUPERFICIAL WOUND INFECTIONS, AND SUPERFICIAL PHLEBITIS. FOUR DEATHS OCCURRED IN THIS GROUP AND WERE NOT RELATED TO THE DEVICE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2711502 | UNKNOWN EEA | STAPLE, IMPLANTABLE | GDW | US SURGICAL PUERTO RICO | UNKNOWN EEA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 67 YR | Unknown | Other |