FDA Adverse Event Injury Summary report: N

GEM MICROVASCULAR ANASTOMOTIC COUPLER

MDR report key: 3528320 · Received December 13, 2013

Report

Report Number
2183620-2013-00015
Event Type
Injury
Date Received
December 13, 2013
Report Date
November 14, 2013
Manufacturer
SYNOVIS SURGICAL INNOVATIONS
Product Code
MVR
PMA / PMN Number
K861985
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT IS NOT AVAILABLE FOR EVAL. A REVIEW OF THE DEVICE HISTORY RECORD WAS NOT POSSIBLE SINCE THE LOT NUMBER WAS UNAVAILABLE.

Description of Event or Problem · 1

VENOUS COUPLER SIZE IN AUTOLOGOUS BREAST RECONSTRUCTION-DOES IT MATTER? WILEY PERIODICALS, INC. MICROSURGERY 33:514-518, 2013. THIS ARTICLE IS A RETROSPECTIVE CHART REVIEW OF PTS UNDERGOING AUTOLOGOUS BREAST RECONSTRUCTION AT NYU MEDICAL CENTER BETWEEN NOVEMBER 2007 AND NOVEMBER 2011. THE 197 PTS UNDERWENT 392 FLAPS, FEATURING 392 GEM COUPLERS, DURING THE STUDY PERIOD. THERE WERE 93 PT COMPLICATIONS NOTED AND ZERO DEVICE MALFUNCTIONS. COMPLICATIONS INCLUDED INCIDENCE OF ARTERIAL INSUFFICIENCY (5), VENOUS INSUFFICIENCY (11), HEMATOMA (13), PARTIAL FLAP LOSS (14), FULL FLAP LOSS (2), FAT NECROSIS (30), AND MASTECTOMY SKIN FLAP NECROSIS (18). THIS REPORT IS FOR THE TWO (2) INCIDENCES OF FULL FLAP LOSS. ALL MEDWATCH REPORTS FOR THIS ARTICLE INCLUDE 2183620-2013-00014 THROUGH 2183620-2013-00020.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
652321 GEM MICROVASCULAR ANASTOMOTIC COUPLER ANASTOMOTIC COUPLER MVR SYNOVIS SURGICAL INNOVATIONS UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention