FDA Adverse Event Other Summary report: N

ZIMMER COLLAGEN REPAIR PATCH

MDR report key: 643446 · Received October 24, 2005

Report

Report Number
9617613-2005-00032
Event Type
Other
Date Received
October 24, 2005
Date of Event
September 26, 2005
Manufacturer
TISSUE SCIENCE LABORATORIES, PLC
Product Code
FTM
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE SURGEON REPAIRED A LARGE ROTATOR CUFF TEAR WITH THE ZIMMER COLLAGEN REPAIR PATCH. FIVE WEEKS LATER THE PT WAS SEEN IN THE SURGEONS OFFICE WHERE THE SURGEON NOTICED REDDENING AND YELLOWISH TINT OF THE SKIN OVER THE INCISION SITE. UPON PRESSING ON THE SHOULDER, THE INCISION OPENED AND PURULENT MATTER DRAINED FROM THE INCISION. THE SURGEON RE-OPERATED THE NEXT DAY TO DEBRIDE THE DEHISCED WOUND AND UPON OPENING THE SHOULDER NOTICED `GELATINOUS' MATERIAL WHERE THE ZIMMER COLLAGEN REPAIR PATCH WAS PLACED. THE PT WAS TREATED INTEROPERATIVELY WITH ANTIBIOTICS AND WHEN A CULTURE WAS OBTAINED THE LAB REPORT WAS NEGATIVE FOR BACTERIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZIMMER COLLAGEN REPAIR PATCH PORCINE DERMAL IMPLANT FTM TISSUE SCIENCE LABORATORIES, PLC Z02 04B36-1

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other