BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ETHICON

    MDR report key: 2163531 · Received July 7, 2011

    Report

    Report Number
    MW5021302
    Event Type
    Injury
    Date Received
    July 7, 2011
    Date of Event
    April 16, 2011
    Report Date
    July 7, 2011
    Manufacturer
    ETHICON
    Product Code
    GAM
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AR, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    SURGICAL WOUND DEHISCENCE. KNOTS STILL IN BOTH ENDS OF SUTURE AND SUTURE BROKE IN MIDDLE. SUTURE 3-0 SUBCUTICULAR STITCH. PT TAKEN BACK TO SURGERY FOR CLOSURE. SUTURE PLACED ON (B)(6) 2011 AND REMOVED ON (B)(6) 2011.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETHICON 0-VICRYL CT-2 27" VCP270H GAM ETHICON UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 19 YR Hospitalization| O