FDA Adverse Event
Malfunction
Summary report: N
SURGISEAL SKIN ADHESIVE
MDR report key: 7813224
·
Received August 23, 2018
Report
- Report Number
- MW5079379
- Event Type
- Malfunction
- Date Received
- August 23, 2018
- Date of Event
- April 5, 2018
- Report Date
- August 22, 2018
- Manufacturer
- ADHEZION BIOMEDICAL LLC
- Product Code
- MPN
- Product Problem
- Yes
- Report Source
- Voluntary report
- Reporter Location
- GA, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Description of Event or Problem · 1
PT HAD A SPINAL CORD STIMULATOR AND T10-T11 THORACIC LAMINECTOMY. THE PT RETURNED TO THE SURGEON'S OFFICE FOR POST-OP VISIT AND HAD VISIBLE RASH-LIKE / RED IRRITATION AROUND THE INCISION SITE. THIS IS AN ADD'L PT IN A 6 MONTH PERIOD WITH COMPLAINTS OF SIMILAR ISSUES. PT WAS REFERRED TO DERMATOLOGY. THERAPY START DATE: (B)(6) 2018; THERAPY END DATE: (B)(6) 2018. REASON FOR USE: SURGICAL INCISION SKIN CLOSURE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 652481 | SURGISEAL SKIN ADHESIVE | SURGISEAL SKIN ADHESIVE | MPN | ADHEZION BIOMEDICAL LLC |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 61 YR | Other |