FDA Adverse Event Death Summary report: N

OMRIX PRESSURE REGULATOR

MDR report key: 2854938 · Received November 27, 2012

Report

Report Number
3003183625-2012-01005
Event Type
Death
Date Received
November 27, 2012
Report Date
November 13, 2012
Manufacturer
OMRIX BIOPHARMACEUTICALS LTD.
Product Code
BXX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THIS WAS A SPONTANEOUS REPORT FROM A SURGEON VIA A SALES REPRESENTATIVE AND CONCERNS A (B)(6) FEMALE FROM THE UNITED STATES: (B)(4). INITIAL INFORMATION WAS PROCESSED WITH ADDITIONAL INFORMATION RECEIVED ON (B)(6) 2012. THE PATIENT'S HEIGHT, WEIGHT AND MEDICAL HISTORY WERE NOT REPORTED. THE PATIENT WAS TREATED WITH EVICEL (HUMAN CLOTTABLE PROTEIN/HUMAN THROMBIN, SOLUTION, TOPICAL) SPRAYED VIA OMRIX PRESSURE REGULATOR FOR HEMOSTASIS AFTER A LAPAROSCOPIC TOTAL HYSTERECTOMY (DATE OF USE AND DOSAGE UNSPECIFIED). THE SURGEON USED EVICEL AT A PREDEFINED PRESSURE ACCORDING TO INSTRUCTIONS FOR USE "IFU" AT A 4-6 CENTIMETER DISTANCE (EXACT PRESSURE NUMBERS NOT REPORTED). CONCOMITANT MEDICATIONS WERE NOT REPORTED. THE SALES REPRESENTATIVE INITIALLY REPORTED THAT DURING A LAPAROSCOPIC HYSTERECTOMY THE PATIENT WENT INTO DEFIBRILLATION AND DIED. UPON FOLLOW-UP, THE SURGEON REPORTED THERE WAS OOZING BLEEDING AT THE VAGINAL CUFF AFTER THE HYSTERECTOMY. ABOUT 10-15 MINUTES AFTER THE EVICEL APPLICATION, WHEN THE SURGERY WAS ALMOST COMPLETED AND THE SKIN WOUND WAS ALREADY BEING CLOSED, THE ANESTHESIOLOGIST ALERTED THE SURGEON THE PATIENT WENT INTO CARDIAC ARREST. THE SURGEON REPORTED THAT HE DID NOT THINK THERE WAS AN AIR EMBOLISM AND CAUSE OF DEATH WAS UNKNOWN. A PATHOLOGY REPORT WAS EXPECTED. THE ACTION TAKEN WITH HUMAN CLOTTABLE PROTEIN/HUMAN THROMBIN WAS NOT APPLICABLE. THE PATIENT DIED FROM CARDIAC ARREST ON AN UNSPECIFIED DATE. THIS REPORT WAS SERIOUS (DEATH) AND REPORTABLE (DEATH AND SERIOUS INJURY). (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OMRIX PRESSURE REGULATOR OTHER BXX OMRIX BIOPHARMACEUTICALS LTD. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 37 YR Death