FDA Adverse Event Malfunction Summary report: N

MONOCRYL PLUS SUTURE

MDR report key: 3243330 · Received July 23, 2013

Report

Report Number
2210968-2013-14235
Event Type
Malfunction
Date Received
July 23, 2013
Date of Event
July 5, 2013
Report Date
July 9, 2013
Manufacturer
ETHICON INC.
Product Code
GAM
PMA / PMN Number
K050845
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

IN ADDITION, A REVIEW OF THE BATCH MANUFACTURING RECORDS WAS CONDUCTED AND THE BATCH MET ALL FINISHED GOODS RELEASE CRITERIA.

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.

Additional Manufacturer Narrative · 1

(B)(4): THE ACTUAL DEVICE INVOLVED IN THIS EVENT WAS RETURNED FOR EVALUATION. A VISUAL INSPECTION OF THE SCANNING ELECTRON MICROSCOPE (SEM) PHOTOS WERE PERFORMED. THE NEEDLES EXHIBITED AMOUNTS OF INTERGRANULAR AND POSSIBLY SOME TRANSGRANULAR FAILURE. THESE FAILURE MODES ARE NOT COMMON FOR AN CT-1 NEEDLE, WHICH TYPICALLY FAILS PRIMARILY IN A DUCTILE MANNER.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT AN UNKNOWN PROCEDURE ON (B)(6) 2013 AND SUTURE WAS USED. UPON OPENING THE SUTURE, THE NEEDLE WAS DETACHED FROM THE SUTURE MATERIAL. THERE WAS NO ADVERSE PATIENT CONSEQUENCE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
343268 MONOCRYL PLUS SUTURE SUTURES - ABSORBABLE GAM ETHICON INC. GA6220

Patients

Seq Age Sex Outcome Treatment
1