FDA Adverse Event Injury Summary report: N

SEPRAFILM (SODIUM HYALURONATE, CARBOXYMETHYLCELLULOSE) MEMBRANE

MDR report key: 2030705 · Received March 18, 2011

Report

Report Number
1220423-2011-00007
Event Type
Injury
Date Received
March 18, 2011
Date of Event
January 26, 2011
Report Date
March 10, 2011
Manufacturer
GENZYME BIOSURGERY (SEPRAFILM/PACK)
Product Code
MCN
PMA / PMN Number
P950034
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

ALLERGIC REACTION [HYPERSENSITIVITY]. PERITONITIS [PERITONITIS]. CASE DESCRIPTION: SPONTANEOUS REPORT RECEIVED ON (B)(6) 2011 FROM A PHYSICIAN VIA A COMPANY REPRESENTATIVE REGARDING A (B)(6) MALE PT. THE PT UNDERWENT A PROCEDURE DURING WHICH SEPRAFILM WAS USED. THE PT EXPERIENCED A PERITONITIS AND ALLERGIC REACTION ON (B)(6) 2011. THE PT WAS HOSPITALIZED ON AN UNK DATE IN 2011. FOR BOTH EVENTS, THE SEVERITY WAS SEVERE AND THE OUTCOME WAS NOT YET RECOVERED. AT THE TIME OF THIS REPORT, THE RELATIONSHIP WAS UNK. NO FURTHER INFO WAS PROVIDED. ADDITIONAL INFO WAS RECEIVED FROM THE PHYSICIAN ON (B)(6) 2011. ON (B)(6) 2011, THE PT HAD A LEFT HEMICOLECTOMY DUE TO DESCENDING COLON CANCER. DURING THE OPERATION, ONE SHEET OF SEPRAFILM, LOT NUMBER UNK, WAS PLACED UNDER THE ABDOMINAL WALL. THE CONCOMITANT MEDICAL DEVICES WERE BAG-DRAIN AND SINGLE USE STAPLER (PRODUCT NAME CEEA). ON (B)(6) 2011, A PERITONITIS AND ALLERGIC REACTION DEVELOPED AT THE WHOLE OF INTRA-ABDOMEN WHICH WAS THE AREA WHERE THE SEPRAFILM HAD BEEN PLACED. AS OF (B)(6) 2011, THE EVENTS WERE ONGOING. THE REPORTING SURGEON ASSESSED THE EVENTS AS SEVERE, SERIOUS, AND UNK RELATIONSHIP WITH SEPRAFILM. ADDITIONALLY, THE SUSPECTED THE PT'S OBESITY AND OTHER CONCOMITANT MEDICAL DEVICES AS CAUSALITIES. NO FURTHER INFO WAS PROVIDED. MANUFACTURER'S COMMENT: THE BENEFIT-RISK RELATIONSHIP OF SEPRAFILM IS NOT AFFECTED BY THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SEPRAFILM (SODIUM HYALURONATE, CARBOXYMETHYLCELLULOSE) MEMBRANE BIORESORBABLE ADHESION BARRIER MCN GENZYME BIOSURGERY (SEPRAFILM/PACK) UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 62 YR Hospitalization