FDA Adverse Event Other Summary report: N

SMARTPLUG

MDR report key: 535020 · Received July 16, 2004

Report

Report Number
2031959-2004-00012
Event Type
Other
Date Received
July 16, 2004
Report Date
July 15, 2004
Manufacturer
MEDENNIUM, INC.
Product Code
LZU
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

"THE DOCTOR BELIEVES HE MAY HAVE HAD A CASE OF CANALICULITIS. HE STATED A PT RETURNED TO HIS OFFICE 6 MONTHS POST INSERTION OF SMARTPLUG WITH PUS PROTRUDING FROM THE VERTICAL CANAL. THE RIGHT EYE HAD SWELLING BY THE LID MARGIN AND THE PT REVEALED THERE HAD BEEN PUS X 3 WEEKS. THE PT HAD NO RELEVANT PREVIOUS HISTORY AND THE PHYSICIAN PUT THE PT ON AN ANTIBIOTIC. THE CASE RESOLVED AND THE PT HAS HAD NO REOCCURRENCES."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMARTPLUG PUNCTUM PLUG LZU MEDENNIUM, INC. MODEL 500 UNK

Patients

Seq Age Sex Outcome Treatment
1 48 YR Other