FDA Adverse Event Death Summary report: N

SILTEX CONTOUR EXPANDER W/INTEGRAL INJ. SITE

MDR report key: 625795 · Received August 9, 2005

Report

Report Number
1645337-2005-00004
Event Type
Death
Date Received
August 9, 2005
Date of Event
July 16, 2005
Report Date
July 17, 2005
Manufacturer
MENTOR
Product Code
LCJ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THIS PT UNDERWENT BILATERAL BREAST RECONSTRUCTION WITH MENTOR TISSUE EXPANDERS IN 2005. THEIR IMMEDIATE POSTOPERATIVE COURSE WAS COMPLICATED BY FEVER AND ATELECTASIS. PT WAS DISHCARGED ON PO DAY 3. SIX DAYS LATER, PT'S SKIN FLAPS WERE OBSERVED TO BE ECCYMOTIC WITH SUPERFICAL EPIDERMOLYSIS. BASED ON THE MEDICAL RECORDS PROVIDED, THIS PT EXPIRED IN ABOUT A WEEK LATER FOLLOWING RAPID ONSET OF SEPSIS AND TOXIC SHOCK, WITH THE SURGICAL SITE AS POSSIBLE SOURCE. APPROXIMATELY 24 HORS PROCEDING DEATH, THE MASTECTOMY SKIN FLAPS HAD BEEN DEBRIDED AND EXPANDERS REMOVED. BASED ON THE OPERATIVE REPORT, NO GROSS PURULENCE WAS NOTED. FINAL WOULD CULTURES HAVE NOT BEEN FORWARD TO MENTOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SILTEX CONTOUR EXPANDER W/INTEGRAL INJ. SITE TISSUE EXPANDER LCJ MENTOR 354-6215 5585620

Patients

Seq Age Sex Outcome Treatment
1 52 YR Death