FDA Adverse Event Other Summary report: N

DERMABOND TOPICAL SKIN ADHESIVE PROPEN DOMESTIC

MDR report key: 546960 · Received October 1, 2004

Report

Report Number
1034548-2004-00015
Event Type
Other
Date Received
October 1, 2004
Report Date
September 28, 2004
Manufacturer
CLOSURE MEDICAL CORP.
Product Code
MPN
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE COMPLAINT WAS OPENED AT ETHICON, INC IN 2004, THE EVENT OCCURRED WITHIN TWO WEEKS PRIOR TO THAT DATE. THE REPORT STATES THE PRODUCT WAS USED TO CLOSE A LACERATION ON THE NOSE OF A PT. THE WOUND WAS THOROUGHLY CLEANED BY THE ATTENDING DOCTOR AND THE WOUND WAS WELL APPROXIMATED. THERE HAVE BEEN SEVERAL ATTEMPTS TO GAIN MORE INFO ON THIS EVENT, BUT AT THIS TIME NO MORE INFO HAS BEEN PROVIDED. PRODUCT WAS NOT RETURNED. THE CURRENT CONDITION OF THE PT IS UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DERMABOND TOPICAL SKIN ADHESIVE PROPEN DOMESTIC TISSUE ADHESIVE FOR SOFT TISSUE APPROX MPN CLOSURE MEDICAL CORP. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 * Other