FDA Adverse Event Injury Summary report: N

COATED VICRYL PLUS ANTIBACTERIAL SUTURE

MDR report key: 702090 · Received April 20, 2006

Report

Report Number
2210968-2006-00307
Event Type
Injury
Date Received
April 20, 2006
Report Date
March 21, 2006
Manufacturer
ETHICON, INC.
Product Code
GAM
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. 510(K)# K022715.

Description of Event or Problem · 1

A PATIENT PRESENTED WITH A SEROMA AT AN UNSPECIFIED TIME FOLLOWING SURGERY. THE PATIENT WAS RETURNED TO SURGERY FOR SXCISION OF THE SEROMA. NO FURTHER DETAILS WERE PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COATED VICRYL PLUS ANTIBACTERIAL SUTURE SUTURE, ABSORBABLE GAM ETHICON, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention