BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LAP-BAND ADJUSTABLE GASTRIC BANDING SYSTEM (UNK SIZE)

    MDR report key: 2844700 · Received November 16, 2012

    Report

    Report Number
    2024601-2012-01239
    Event Type
    Injury
    Date Received
    November 16, 2012
    Date of Event
    October 19, 2012
    Report Date
    October 19, 2012
    Manufacturer
    ALLERGAN
    Product Code
    LTI
    PMA / PMN Number
    P000008
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN
    Reporter Occupation
    NO INFORMATION

    Narratives

    Additional Manufacturer Narrative · 1

    TAPER UNK. MEDWATCH SENT TO FDA ON 11/16/2012. NO CONTACT INFO IS AVAILABLE TO ALLERGAN, AT THIS TIME, TO ASK THE REPORTER FOR THE RETURN OF THE PRODUCT FOR ANALYSIS, TO INDICATE THE PRODUCT SERIAL NUMBER, THE DATE OF THE EVENT, AND THE IMPLANT AND EXPLANT DATES. ALLERGAN WILL CONTINUE ATTEMPTS TO OBTAIN THIS INFO. AT THIS TIME, THE CONNECTOR TYPE CANNOT BE IDENTIFIED NOR AN ASSUMPTION BE MADE AS TO THE TYPE OF CONNECTOR ASSOCIATED WITH THIS COMPLAINT BECAUSE NO SERIAL NUMBER OR IMPLANT DATE WAS PROVIDED IN THE ABSTRACT. VISUAL EXAMINATION MAY DETERMINE THE CONNECTOR TYPE ASSOCIATED WITH THIS REPORT. ALLERGAN HAS NOT RECEIVED THE PRODUCT. THEREFORE NO ANALYSIS OR TESTING HAS BEEN DONE. EROSION, POUCH DILATION, SLIPPAGE OF THE DEVICE, AND INADEQUATE WEIGHT LOSS/WEIGHT FLUCTUATIONS ARE SURGICAL AND PHYSIOLOGICAL COMPLICATIONS AND AN ANALYSIS OF THE DEVICE GENERALLY DOES NOT ASSIST ALLERGAN IN DETERMINING A PROBABLE CAUSE FOR THESE EVENTS.

    Description of Event or Problem · 1

    RECEIVED ABSTRACT PUBLISHED IN "OBES SURG (2012) 22:1315-1419" THROUGH FORWARDED PRODUCTWATCH FROM ALLERGAN GLIS DEPARTMENT. ABSTRACT: REVISIONAL SURGERY AFTER LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING. SONI, VANDANA. OBESITY SURGERY, (SEP 2012) VOL, 22. NO. 9, PP. 1350-1351. NO ADD'L INFO IS AVAILABLE AT THIS TIME. IT IS NOT CLEAR IF THE DEVICES ASSOCIATED WITH THE ABSTRACT ARE ALLERGAN DEVICES. THE DEVICES ARE NOT AVAILABLE TO ALLERGAN FOR PRODUCT ANALYSIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LAP-BAND ADJUSTABLE GASTRIC BANDING SYSTEM (UNK SIZE) LTI ALLERGAN NA NI

    Patients

    Seq Age Sex Outcome Treatment
    1 NI Required Intervention