FDA Adverse Event Other Summary report: N

PMT INTEGRA TISSUE EXPANDER

MDR report key: 1706452 · Received May 28, 2010

Report

Report Number
2182979-2008-00006
Event Type
Other
Date Received
May 28, 2010
Date of Event
February 1, 2008
Report Date
May 28, 2010
Manufacturer
PMT CORP.
Product Code
FWM
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING INITIATED FOLLOWING AN FDA FIELD AUDIT RECOMMENDING A COMPLETE REVIEW OF PAST COMPLAINTS. THIS FILING IS A RESULT OF THAT REVIEW.

Description of Event or Problem · 1

THE HOSPITAL CONTACTED PMT ON (B)(6) 2008, TO REPORT THAT A TISSUE EXPANDER LEAKED DURING SURGERY. THE EXPANDER WAS REMOVED BUT WE DO NOT KNOW IF IT WAS REPLACED OR IF THE PROCEDURE WAS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PMT INTEGRA TISSUE EXPANDER TISSUE EXPANDER FWM PMT CORP. 3610ES-76 121406

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention