FDA Adverse Event Malfunction Summary report: N

MONOCRYL PLUS ANTIBACTERIAL SUTURES

MDR report key: 2992228 · Received March 7, 2013

Report

Report Number
2210968-2013-02086
Event Type
Malfunction
Date Received
March 7, 2013
Date of Event
February 12, 2013
Report Date
February 15, 2013
Manufacturer
ETHICON, INC.
Product Code
GAM
PMA / PMN Number
K050845
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NO
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCLUSION: THE PRODUCT UPON WHICH THIS MEDWATCH IS BASED IS ANTICIPATED. ONCE THE PRODUCT IS RECEIVED, ANY FURTHER INFORMATION DERIVED FROM THE EVALUATION WILL BE SUBMITTED IN A SUPPLEMENTAL 3500A FORM. IN ADDITION, A REVIEW OF THE BATCH MANUFACTURING RECORDS WAS CONDUCTED AND THE BATCH MET ALL FINISHED GOODS RELEASE CRITERIA. THIS IS ONE OF FOUR MEDWATCHES BEING SUBMITTED AS FOUR DEVICES WERE INVOLVED IN THIS EVENT. SEE ALSO MEDWATCHES 2210968-2013-02083,2210968-2013-02085, AND 2210968-2013-02087. THE SAME PATIENT IS REPRESENTED IN EACH MEDWATCH.

Additional Manufacturer Narrative · 1

(B)(4): ADDITIONAL INFORMATION WAS RECEIVED THAT CLARIFIES THE NUMBER OF DEVICES INVOLVED IN THIS EVENT. THIS MEDWATCH REPORT # 2210968-2013-02086 IS BEING VOIDED. PLEASE SEE MEDWATCH REPORT # 2210968-2013-02083 AND 2210968-2013-02085 FOR ALL INFORMATION REGARDING THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT AN ABDOMINOPLASTY ON (B)(6) 2013 AND SUTURE WAS USED. DURING THE PROCEDURE THE NEEDLE PULLED OFF THE SUTURE. THE CASE WAS COMPLETED WITH A LIKE DEVICE. THERE WERE NO ADVERSE PATIENT CONSEQUENCES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
97705 MONOCRYL PLUS ANTIBACTERIAL SUTURES SUTURES, ABSORBABLE GAM ETHICON, INC. NA EM5DKWV

Patients

Seq Age Sex Outcome Treatment
1