FDA Adverse Event Injury Summary report: N

COPIOS PERICARDIUM MEMBRANE

MDR report key: 18538754 · Received January 18, 2024

Report

Report Number
3002924436-2023-00008
Event Type
Injury
Date Received
January 18, 2024
Report Date
January 18, 2024
Manufacturer
TUTOGEN MEDICAL, GMBH
Product Code
NPL
PMA / PMN Number
K073097
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

UNIQUE IDENTIFIERS HAVE NOT BEEN PROVIDED TO DATE. IN ORDER TO CONDUCT A COMPREHENSIVE BATCH RECORDS ANALYSIS, THIS INFORMATION IS NEEDED. IF ADDITIONAL INFORMATION BECOMES AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

ON 12/19/2023, RTI SURGICAL, INC. AND TUTOGEN MEDICAL GMBH (TMI), A WHOLLY SUBSIDIARY OF RTI SURGICAL, RECEIVED A COMPLAINT FROM ZIMVIE UK. THE REPORTED COMPLAINT INDICATED THAT THE PATIENT UNDERWENT A DENTAL PROCEDURE AT TOOTH SITES #35-37. A PUROS® ALLOGRAFT CUSTOMIZED BLOCK AND A COPIOS PERICARDIUM MEMBRANE WERE IMPLANTED. ON AN UNKNOWN DATE, THE PATIENT DEVELOPED AN INFECTION, WOUND DEHISCENCE EXPOSING THE BONE BLOCK AND NON-INTEGRATION. THE PATIENT WILL HAVE TO RETURN AT A FUTURE DATE TO COMPLETE THE PROCEDURE. TO DATE, NO ADDITIONAL INFORMATION HAS BEEN PROVIDED TO RTI FOR REVIEW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
818530 COPIOS PERICARDIUM MEMBRANE DENTAL MEMBRANE NPL TUTOGEN MEDICAL, GMBH

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other