BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DEMEDIOX

    MDR report key: 18767938 · Received February 23, 2024

    Report

    Report Number
    3007895168-2024-00002
    Event Type
    Injury
    Date Received
    February 23, 2024
    Date of Event
    December 27, 2023
    Report Date
    February 1, 2024
    Manufacturer
    DEMETECH CORPORATION
    Product Code
    NEW
    UDI-DI
    10652927777489
    PMA / PMN Number
    K082097
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    UDI RELATED DATA QUALITY UPDATES ONLY THIS REPORT REPRESENTS A CORRECTION TO A PREVIOUSLY SUBMITTED MDR 3007895168-2024-00002 BRAND NAME: DEMEDIOX. VERSION OR MODEL: PX2X783090A16MB. COMPANY NAME: DEMETECH CORPORATION. PRIMARY DI NUMBER: (B)(6) . DEVICE DESCRIPTION: ABSORBABLE POLYDIOXANONE SURGICAL SUTURE. FDA PREMARKET SUBMISSION NUMBER: K082097.

    Description of Event or Problem · 0

    JANUARY 25TH 2024, HCP REPORTED THAT THE PATIENT HAD PDO THREADS IMPLANTED ON (B)(6) 2023. ACCORDING TO THE HCP, THE PATIENT EXPERIENCED THREAD POKING UNDER THE SKIN AT THE ENDPOINT. ON THE FOLLOW UP APPOINTMENT ON (B)(6) 2023, HCP REPORTED HAVING REMOVED ONE PIECE OF BROKEN PDO THREADS LOCATED ON THE RIGHT SIDE OF THE PATIENT'S FACE. MEDICAL ADVICE FROM THE MEDICAL DIRECTOR WAS OFFERED BUT THE HCP DECLINED. FEBRUARY 7TH, 2024, AFTER CONDUCTING A FOLLOW UP CONTACT WITH THE PRACTICE MANAGER, IT WAS CONFIRMED THAT THE PATIENT IS IN GOOD CONDITION.

    Description of Event or Problem · 0

    (B)(6) 2024, HCP REPORTED THAT THE PATIENT HAD PDO THREADS IMPLANTED ON (B)(6) 2023. ACCORDING TO THE HCP, THE PATIENT EXPERIENCED THREAD POKING UNDER THE SKIN AT THE ENDPOINT. ON THE FOLLOW UP APPOINTMENT ON (B)(6) 2023, HCP REPORTED HAVING REMOVED ONE PIECE OF BROKEN PDO THREADS LOCATED ON THE RIGHT SIDE OF THE PATIENT'S FACE. MEDICAL ADVICE FROM THE MEDICAL DIRECTOR WAS OFFERED BUT THE HCP DECLINED. (B)(6) 2024, AFTER CONDUCTING A FOLLOW UP CONTACT WITH THE PRACTICE MANAGER, IT WAS CONFIRMED THAT THE PATIENT IS IN GOOD CONDITION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    113317 DEMEDIOX ABSORBABLE POLYDIOXANONE SURGICAL SUTURE NEW DEMETECH CORPORATION PX2X783090A16MB L107-22 10652927777489

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Female Required Intervention