FDA Adverse Event Other Summary report: N

SOLETRA

MDR report key: 526188 · Received May 21, 2004

Report

Report Number
6000032-2004-00653
Event Type
Other
Date Received
May 21, 2004
Date of Event
January 26, 2004
Report Date
April 2, 2004
Manufacturer
MEL REL, INC.
Product Code
MHY
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

HCP REPORTED PT INFECTION WAS NOT MENINGITIS. INFECTION SIGNS AND SYMPTOMS WERE REDNESS, INCISIONAL WOUND OPENING AND A SOFT, SLIGHT PURPLE AREA. THE PRIMARY LOCATION OF THE INFECTION WAS THE SCALP. CULTURES WERE OBTAINED FROM THE SCALP WOUND AND THE TYPE OF ORGANISM FOUND WAS SERRATIA. THE PT WAS TREATED WITH IV ANTIBIOTICS AND THE TOTAL DEVICE SYSTEM WAS EXPLANTED. THE FIRST INFECTION RESOLVED AND THE SECOND INFECTION IS IN-PROGRESS. THE DEVICE WAS EXPLANTED BUT NOT RETURNED TO THE MANUFACTURER FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOLETRA IPG MHY MEL REL, INC. 7426 NA

Patients

Seq Age Sex Outcome Treatment
1 50 YR Other LEAD MODEL 3387 LOT# J0309461V IMP:2003,| EXPLANT: UNK.| EXPLANT: UNK,| EXT MODEL 7428 LOT# NHU002475V, IMPLANT: 2003,