FDA Adverse Event Injury Summary report: N

GORE SEAMGUARD® BIOABSORBABLE STAPLE LINE REINFORCEMENT MATERIAL

MDR report key: 4012118 · Received August 15, 2014

Report

Report Number
3003910212-2014-00023
Event Type
Injury
Date Received
August 15, 2014
Date of Event
May 19, 2014
Report Date
October 8, 2014
Manufacturer
W.L. GORE & ASSOCIATES
Product Code
FTM
PMA / PMN Number
K043056
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

SALEH, MEHDI. 2014 LAPAROSCOPIC SLEEVE GASTRECTOMY USING A SYNTHETIC BIOABSORBABLE STAPLE LINE REINFORCEMENT MATERIAL: 6 YEAR OUTCOMES. 1-47.

Description of Event or Problem · 1

THIS REPORT IS BEING SUBMITTED AS FOLLOW UP 1 TO MFR REPORT 3003910212-2014-00023 .

Description of Event or Problem · 1

GORE RECEIVED AN ARTICLE, "LAPAROSCOPIC SLEEVE GASTRECTOMY USING A SYNTHETIC STAPLE LINE REINFORCEMENT MATERIAL: 6 YEAR OUTCOMES." REVIEW OF THE ARTICLE IDENTIFIED THE USE OF GORE® SEAMGUARD® BIOABSORBABLE STAPLE LINE REINFORCEMENT FROM DECEMBER 2007 UNTIL MAY 2013. DURING THIS TIME COMPLICATIONS THAT WERE OBSERVED WERE: 2 STAPLE LINE LEAKS THAT REQUIRED REOPERATION WITH INTRA-OPERATIVE BLOOD TRANSFUSION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
490456 GORE SEAMGUARD® BIOABSORBABLE STAPLE LINE REINFORCEMENT MATERIAL MESH, SURGICAL FTM W.L. GORE & ASSOCIATES

Patients

Seq Age Sex Outcome Treatment
1 45 YR Other| R