FDA Adverse Event Injury Summary report: N

COATED VICRYL (POLYGLACTIN 910) SUTURE

MDR report key: 703931 · Received April 25, 2006

Report

Report Number
2210968-2006-00317
Event Type
Injury
Date Received
April 25, 2006
Date of Event
February 13, 2006
Report Date
March 31, 2006
Manufacturer
ETHICON, INC.
Product Code
GAM
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO CONCLUSION CAN BE DRAWN AT THIS TIME. K946271.

Description of Event or Problem · 1

INTERNATIONAL AFFILIATE REPORTED THAT THE PT PRESENTED WITH BLEEDING NINE DAYS FOLLOWING HERMORRIOIDECTOMY. IT WAS RPEORTED THAT THE SUTURE WAS BROKEN. THE PT WAS RESUTURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COATED VICRYL (POLYGLACTIN 910) SUTURE SUTURE, ABSORBABLE GAM ETHICON, INC. NA ULZ406

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention