FDA Adverse Event Other Summary report: N

DERM X-RAY SPG 4X4 16 PLY ALT

MDR report key: 3817503 · Received May 5, 2014

Report

Report Number
1282497-2014-00035
Event Type
Other
Date Received
May 5, 2014
Report Date
May 1, 2014
Manufacturer
ALLMED MEDICAL PRODUCTS
Product Code
GDY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

AN INVESTIGATION IS CURRENTLY UNDERWAY, UPON COMPLETION THE RESULTS WILL BE FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO COVIDIEN ON (B)(6) 2014 THAT A CUSTOMER HAD AN ISSUE WITH AN X-RAY SPONGE. THE CUSTOMER STATES THAT PIECES OF THE RAYTEC SPONGES IN THE LAPAROTOMY PACKS ARE FALLING INTO THE WOUNDS. THE CUSTOMER REPORTS DURING THE CASE, THE SURGEON NOTICED PIECES OF THE RAYTEC IN THE INCISION. THEY REMOVED THEM BY HAND AND STARTED USING THE LAP SPONGE. THE PROCEDURE WAS A HERNIA REPAIR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
266172 DERM X-RAY SPG 4X4 16 PLY ALT X-RAY SPONGE GDY ALLMED MEDICAL PRODUCTS 441601A 13259A

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other