FDA Adverse Event Injury Summary report: N

TUMARK® PROFESSIONAL Q FOR BREVERA® PETITE

MDR report key: 20906894 · Received December 11, 2024

Report

Report Number
1000408433-2024-00006
Event Type
Injury
Date Received
December 11, 2024
Report Date
December 11, 2024
Manufacturer
SOMATEX MEDICAL TECHNOLOGIES GMBH
Product Code
NEU
UDI-DI
04250195611338
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

D4: LOT NUMBER OF THE DEVICE NOT PROVIDED BY THE COMPLAINANT; THEREFORE, THE UDI, EXPIRATION AND MANUFACTURING DATES ARE NOT KNOWN. DEVICE HISTORY RECORD (DHR) REVIEW WAS UNABLE TO BE CONDUCTED FOR THE DISPOSABLE DEVICE AS THE IDENTIFICATION NUMBERS WERE NOT PROVIDED BY THE COMPLAINANT. H3: THE DEVICE INVOLVED IN THIS EVENT WAS NOT RETURNED FOR EVALUATION PURPOSES THEREFORE VISUAL AND FUNCTIONAL ANALYSIS OF THE PRODUCT COULD NOT BE PERFORMED. WE ARE UNABLE TO CONFIRM A RELATIONSHIP BETWEEN THE DEVICE AND THE ISSUE REPORTED. THE INFORMATION OBTAINED DURING COMPLAINT INVESTIGATION WILL BE INCLUDED IN OUR GLOBAL COMPLAINT TRENDING AND PRODUCT SURVEILLANCE WILL CONTINUE TO MONITOR COMPLAINTS OF THIS TYPE FOR ADVERSE TRENDS. IF THE PRODUCT IS RECEIVED OR ADDITIONAL INFORMATION IS OBTAINED, THE INVESTIGATION WILL BE REOPENED ACCORDINGLY PER STANDARD OPERATING PROCEDURE.

Description of Event or Problem · 0

HOLOGIC RECEIVED INFORMATION THROUGH A RETROSPECTIVE SURVEY RELATED TO PATIENT RECORDS. IT WAS DOCUMENTED THAT ON AN UNKNOWN DATE IN (B)(6) 2024 A PATIENT EXPERIENCED INFLAMMATION THAT RESOLVED WITHOUT MEDICAL INTERVENTION. THE ISSUE WAS REPORTED AS HAPPENED 1 MONTH AFTER IMPLANTATION. NO OTHER INFORMATION WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2428425 TUMARK® PROFESSIONAL Q FOR BREVERA® PETITE MARKER, RADIOGRAPHIC, IMPLANTABLE NEU SOMATEX MEDICAL TECHNOLOGIES GMBH TUMARK-BREV-P-Q 04250195611338

Patients

Seq Age Sex Outcome Treatment
1 NA Female Other