FDA Adverse Event Injury Summary report: N

REACTIV8

MDR report key: 20253655 · Received September 19, 2024

Report

Report Number
3013017877-2024-00070
Event Type
Injury
Date Received
September 19, 2024
Date of Event
August 22, 2024
Report Date
November 2, 2024
Manufacturer
MAINSTAY MEDICAL LIMITED
Product Code
QLK
UDI-DI
05391527770015
PMA / PMN Number
P190021
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

MML REFERENCE # (B)(4). NO ANOMALIES WERE OBSERVED ASSOCIATED WITH THE DEVICE DURING THE EVALUATION. THE IPG PASSED FUNCTIONAL TESTING AND OPERATED WITHIN THE MANUFACTURING SPECIFICATIONS. BOTH LEADS WERE CUT DURING THE EXPLANT; THEREFORE, NO FUNCTIONAL TESTING COULD BE PERFORMED. THE VISUAL INSPECTION FOUND NO NON-CONFORMANCES ON BOTH LEADS. UPDATED H6.

Additional Manufacturer Narrative · 0

MML REFERENCE # (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT SURGERY TO REMOVE THE REACTIV8 SYSTEM THREE WEEKS AFTER THE IMPLANT DUE TO A SUSPECTED WOUND INFECTION. THE DEVICE WAS REMOVED AND INTACT. THERE WAS NO REPORT OF PATIENT HARM OR INJURY. FURTHER INFORMATION WAS RECEIVED STATING THAT THE PATIENT DID NOT HAVE AN INFECTION BUT A WOUND-HEALING DISORDER ON BOTH SIDES DUE TO NICOTINE ADDICTION. WOUND SWAB RESULTS SHOWED NORMAL SKIN GERMS. THE PATIENT WAS TREATED WITH ORAL ANTIBIOTICS. ALTHOUGH REQUESTED, PATIENT DEMOGRAPHIC INFORMATION WAS NOT PROVIDED. THE DEVICE HISTORY RECORD WAS REVIEWED. THERE WERE NO NON-CONFORMANCES THAT WOULD HAVE CONTRIBUTED TO THE ALLEGED WOULD HEALING ISSUE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT UNDERWENT SURGERY TO REMOVE THE REACTIV8 SYSTEM THREE WEEKS AFTER THE IMPLANT DUE TO A SUSPECTED WOUND INFECTION. THE DEVICE WAS REMOVED AND INTACT. THERE WAS NO REPORT OF PATIENT HARM OR INJURY. FURTHER INFORMATION WAS RECEIVED STATING THAT THE PATIENT DID NOT HAVE AN INFECTION BUT A WOUND-HEALING DISORDER ON BOTH SIDES DUE TO NICOTINE ADDICTION. WOUND SWAB RESULTS SHOWED NORMAL SKIN GERMS. THE PATIENT WAS TREATED WITH ORAL ANTIBIOTICS. ALTHOUGH REQUESTED, PATIENT DEMOGRAPHIC INFORMATION WAS NOT PROVIDED. THE DEVICE HISTORY RECORD WAS REVIEWED. THERE WERE NO NON-CONFORMANCES THAT WOULD HAVE CONTRIBUTED TO THE ALLEGED ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2527808 REACTIV8 REACTIV8 SYSTEM QLK MAINSTAY MEDICAL LIMITED 5100 / 8145 05391527770015

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other