FDA Adverse Event Other Summary report: N

GENEX

MDR report key: 3204682 · Received June 28, 2013

Report

Report Number
9617083-2013-00010
Event Type
Other
Date Received
June 28, 2013
Report Date
June 27, 2013
Manufacturer
BIOCOMPOSITES LTD.
Product Code
MQV
PMA / PMN Number
K082381
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ALTHOUGH THE PATIENT HAD NO SIGNS OF ADVERSE REACTION, THE PRODUCT WAS EXPLANTED AND SENT FOR MICROBIOLOGICAL ANALYSIS. BIOCOMPOSITES STIMULAN RAPID CURE WAS THEN USED TO COMPLETE THE PROCEDURE.

Description of Event or Problem · 1

REPORTED TO THE MFR THAT A PATIENT BEING TREATED IN (B)(6) HAD BEEN PROVIDED WITH A 'DEMO ONLY' PACK FOR INTEREST. THE PACK HAD BEEN HANDED BY THE PATIENT TO THE SURGEON, WHO IMPLANTED THE PRODUCT RATHER THAN THE STERILE PRODUCT PROVIDED BY THE SALES REPRESENTATIVE IN (B)(6) .

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
295025 GENEX GENEX MQV BIOCOMPOSITES LTD. NOT CONFIRMED NOT CONFIRMED

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention