FDA Adverse Event Injury Summary report: N

DERMABOND 2

MDR report key: 2833114 · Received November 15, 2012

Report

Report Number
2210968-2012-07340
Event Type
Injury
Date Received
November 15, 2012
Report Date
October 23, 2012
Manufacturer
ETHICON, INC.
Product Code
MPN
PMA / PMN Number
P960052
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT A CESAREAN SECTION ON (B)(6) 2012 AND TOPICAL SKIN ADHESIVE WAS USED. THE PATIENT RETURNED ON (B)(6) 2012 WITH AN ECOLI INFECTION. THE WOUND WAS DEBRIDED, DRAINED, AND PACKED. THE PATIENT WAS ALSO PLACED ON ANTIBIOTICS. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DERMABOND 2 ADHESIVE, TOPICAL SKIN MPN ETHICON, INC. NA NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention