FDA Adverse Event Injury Summary report: N

UNKNOWN DUET SULU

MDR report key: 2644889 · Received June 28, 2012

Report

Report Number
1219930-2012-00563
Event Type
Injury
Date Received
June 28, 2012
Report Date
June 21, 2012
Manufacturer
COVIDIEN LP, FORMERLY REGISTERED AS UNITED STATES
Product Code
GDW
PMA / PMN Number
K080898
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PROCEDURE: SLEEVE GASTRECTOMY. ACCORDING TO THE REPORTER: BETWEEN (B)(6) 2008 AND (B)(6) 2011, WE RETROSPECTIVELY REVIEWED THE MEDICAL RECORDS OF 116 CONSECUTIVE PTS THAT UNDERWENT LSG WITH STAPLE LINE BUTTRESS REINFORCEMENT AT AN (B)(6) HOSPITAL WITH ADVANCED BARIATRIC FELLOWSHIP. THERE WERE 116 CONSECUTIVE PTS THAT UNDERWENT LSG WITH THE DUET TRS AS PART OF A COMPREHENSIVE WEIGHT MANAGEMENT STRATEGY THROUGH THE WEIGHT WISE PROGRAM INCLUDED IN THE ANALYSIS. THE REPORTERS OBSERVED ONE CASE OF BLEEDING FROM THE GASTRIC STAPLE LINE, WHICH REQUIRED REOPERATION WITH LOCAL LAPAROSCOPIC OVER SEWING WITH CONTINUOUS SUTURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN DUET SULU NONE GDW COVIDIEN LP, FORMERLY REGISTERED AS UNITED STATES

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R