FDA Adverse Event Injury Summary report: N

MONOCRYL PLUS SUTURE

MDR report key: 4222809 · Received November 4, 2014

Report

Report Number
2210968-2014-15256
Event Type
Injury
Date Received
November 4, 2014
Date of Event
September 30, 2014
Report Date
October 17, 2014
Manufacturer
ETHICON INC.
Product Code
GAM
PMA / PMN Number
K050845
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY.

Additional Manufacturer Narrative · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT MICROSURGICAL SPERM EXTRACTION ON (B)(6) 2014 AND SUTURE WAS USED TO CLOSE THE SKIN. THE PATIENT DEVELOPED A WOUND DEHISCENCE ON (B)(6) 2014. THE WOUND WAS ALLOWED TO HEAL BY SECONDARY INTENTION. THERE WAS NO SURGICAL INTERVENTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT SCROTAL SURGERY ON AN UNKNOWN DATE AND SUTURE WAS USED TO CLOSE THE INCISION. THE PATIENT DEVELOPED A WOUND DEHISCENCE. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
707294 MONOCRYL PLUS SUTURE SUTURE, ABSORBABLE, SYNTHETIC GAM ETHICON INC. UNK ASKU

Patients

Seq Age Sex Outcome Treatment
1 36 YR Other