FDA Adverse Event Injury Summary report: N

ENDO STITCH SURGIDAC 2/0 48 GRN DLU SU

MDR report key: 2042063 · Received March 29, 2011

Report

Report Number
1219930-2011-00247
Event Type
Injury
Date Received
March 29, 2011
Report Date
February 28, 2011
Manufacturer
UNITED STATES SURGICAL
Product Code
KOG
PMA / PMN Number
K934738
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PROCEDURE: ROUX-EN-Y. ACCORDING TO THE REPORTER: THE SURGEON USED THE DEVICE TO CLOSE THE TRANSVERSE MESOCOLON AREA. SHE HAS HAD 4 PATIENTS THAT HAVE EXPERIENCED FAT NECROSIS AND CALCIFICATION CAUSING STENOSIS IN THE AREA OF THE SUTURE (TRANSVERSE MESOCOLON). IN A COUPLE OF THE CASES, SHE HAS HAD TO RE-OPERATE TO REMOVE THE CALCIFICATION AND OPEN THE AREA UP. THIS SEEMS TO OCCUR 6-12 MONTHS POST-OPERATIVELY WITH THE CALCIFICATION OF TISSUE. PATIENT STATUS: FINE AFTER RE-OPERATION. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDO STITCH SURGIDAC 2/0 48 GRN DLU SU DISPOSABLE SUTURING DEVICE SULU KOG UNITED STATES SURGICAL UNK

Patients

Seq Age Sex Outcome Treatment
1 Other| R