FDA Adverse Event Other Summary report: N

DURAGEN PLUS DURAL REGENERATION MATRIX 3X3 1 PA

MDR report key: 1648150 · Received March 31, 2010

Report

Report Number
1121308-2010-00008
Event Type
Other
Date Received
March 31, 2010
Date of Event
March 18, 2010
Report Date
March 31, 2010
Product Code
GXQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE INVOLVED IN THE REPORTED INCIDENT IS NOT EXPECTED TO BE RECEIVED FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFO.

Description of Event or Problem · 1

THE REPORTING FACILITY DESCRIBED AN EVENT INVOLVING A PT. THE SURGEON PLACED ONE PIECE OF DURAGEN-(B)(4) OVER CRANIECTOMY SITE. THE PT EXPERIENCED AN INFLAMMATORY REACTION FIVE WEEKS POST OPERATIVELY. THE DURAGEN WAS REMOVED. MICROBIAL CULTURES WERE OBTAINED AND NEGATIVE. PT WAS DISCHARGED ON (B)(6) 2010.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DURAGEN PLUS DURAL REGENERATION MATRIX 3X3 1 PA NA GXQ

Patients

Seq Age Sex Outcome Treatment
1 60 YR Other