FDA Adverse Event Other Summary report: N

GENEX PUTTY

MDR report key: 3350062 · Received September 10, 2013

Report

Report Number
9617083-2013-00015
Event Type
Other
Date Received
September 10, 2013
Date of Event
August 6, 2013
Report Date
August 7, 2013
Manufacturer
BIOCOMPOSITES LTD.
Product Code
MQV
PMA / PMN Number
K062911
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
EI
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUSPECTED ROOT CAUSES: BASED ON THE INFO PROVIDED, THE DESCRIPTION OF EVENTS AND ABSENCE OF INFECTION SOUNDS CONSISTENT WITH MIGRATION OF GENEX PUTTY. THIS IS A POTENTIAL RISK WHEN USED IN UNCONTAINED DEFECTS. GENEX PUTTY IS INDICATED TO BE GENTLY PACKED INTO VOIDS OR DEFECTS OF THE SKELETAL SYSTEM AND IS SELDOM USED IN LATERAL GUTTERS AS THE AREA CAN BE QUITE BLOODY AND THE PUTTY NOT WELL CONTAINED. THE SURGEON HAD NOT USED THE PRODUCT BEFORE AND MAY HAVE BEEN UNFAMILIAR WITH THE RECOMMENDED USE. THE PT HAS BEEN DISCHARGED AND RETURNED HOME.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THE FOLLOWING: FOLLOWING SURGERY, DURING WASH OUT ON (B)(6) 2013, IT WAS NOTED THAT THERE WAS A REDNESS AROUND THE WOUND AND THAT THERE WAS 'WHITE PUS' EMITTED. THE GENEX PUTTY WAS SEEN TO MIGRATE FROM WHERE IT WAS PUT. INFECTION SUSPECTED, ALTHOUGH LATER CONFIRMED AS BEING NEGATIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
454217 GENEX PUTTY GENEX PUTTY MQV BIOCOMPOSITES LTD. 03/13-GP98

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention