FDA Adverse Event Injury Summary report: N

ALOE VESTA PROTECTIVE OINTMENT (AVPO)

MDR report key: 3975177 · Received July 2, 2014

Report

Report Number
1049092-2014-00258
Event Type
Injury
Date Received
July 2, 2014
Date of Event
June 6, 2014
Report Date
June 6, 2014
Manufacturer
CONVATEC, A DIVISION OF E.R. SQUIBB & SONS L.L.C.
Product Code
EXE
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

BASED ON THE AVAILABLE INFO, THIS EVENT IS DEEMED A SERIOUS INJURY. THEN NURSE HAS BEEN CONTACTED VIA VOICEMAIL TO GATHER FURTHER INFO REGARDING THESE CASES. THE TERRITORY MGR (TM) IS INVOLVED IN THE CASE AND IS ASSISTING CONVATEC TO ASCERTAIN ADDITIONAL INFO. NO ADDITIONAL EVENT/PT DETAILS HAVE BEEN PROVIDED TO DATE. A RETURN SAMPLE FOR EVALUATION IS NOT EXPECTED. SHOULD ADDITIONAL INFO BECOME AVAILABLE, A FOLLOW-U P REPORT WILL BE SUBMITTED. PLEASE NOTE: THERE WERE THREE (3) PICU PATIENTS AFFECTED; THEREFORE A SEPARATED FDA 3500A FORM HAS BEEN GENERATED TO ADDRESS THE OTHER TWO (2) CASES REPORTED UNDER PT IDENTIFIER(S): (B)(6). REPORTED TO THE FDA ON 07/01/2014. NOTE: THE ACTUAL DATE OF EVENT IS UNK, SO THE DATE USED WAS THE DATE CONVATEC BECAME AWARE. CONVATEC WILL CONTINUE TO TRACK AND MONITOR SUCH COMPLAINTS ACCORDING TO CONVATEC INC'S COMPLAINT HANDLING AND CAPA PROCEDURES.

Description of Event or Problem · 1

IT IS REPORTED THAT THREE (3) CASES OF PEDIATRIC END-USERS IN PEDIATRIC INTENSIVE CARE UNIT (PICU) WITH A FOLEY CATHETER IN PLACE DEVELOPED CANDIDA INFECTION OF THE URINE AFTER THE USE OF ALOE VESTA PROTECTIVE OINTMENT TO THE PERIANAL AREA. IT IS FURTHER REPORTED THAT TWO (2) MORE DEVELOPED UNSPECIFIED BACTERIAL INFECTION IN URINE WHILE CATHETER IN PLACE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
386128 ALOE VESTA PROTECTIVE OINTMENT (AVPO) NONE EXE CONVATEC, A DIVISION OF E.R. SQUIBB & SONS L.L.C.

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention