FDA Adverse Event Injury Summary report: N

PREVENA PLUS¿ INCISION MANAGEMENT SYSTEM

MDR report key: 8809147 · Received July 19, 2019

Report

Report Number
3009897021-2019-00089
Event Type
Injury
Date Received
July 19, 2019
Date of Event
October 1, 2018
Report Date
August 9, 2019
Manufacturer
KINETIC CONCEPTS, INC.
Product Code
OMP
PMA / PMN Number
K153199
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
117

Narratives

Additional Manufacturer Narrative · 0

SENT ON (B)(6) 2019: SECTION B5 STATED, "ON (B)(6) 2019, THE... BY THE PREVENA¿ INCISION MANAGEMENT SYSTEM." CORRECTION: "ON (B)(6) 2019, THE...BY THE PREVENA PLUS¿ INCISION MANAGEMENT SYSTEM." SECTION D1 STATED, "PREVENA¿ INCISION MANAGEMENT SYSTEM" CORRECTION: "PREVENA PLUS¿ INCISION MANAGEMENT SYSTEM" SECTION D4 STATED, "WNDPRV" CORRECTION "WNDPPL" SECTION G5 STATED, "K100821" CORRECTION "K153199" SECTION H10 STATED, "BASED ON THE INFORMATION. TO THE PREVENA¿ INCISION MANAGEMENT SYSTEM." CORRECTION: "BASED ON THE INFORMATION.TO THE PREVENA PLUS¿ INCISION MANAGEMENT SYSTEM." BASED ON THE DEVICE CORRECTION AND NO ADDITIONAL INFORMATION PROVIDED, KCI'S ASSESSMENT REMAINS THE SAME; IT CANNOT BE DETERMINED THAT THE ALLEGED INFECTION IS RELATED TO PREVENA PLUS¿ INCISION MANAGEMENT SYSTEM. MULTIPLE UNSUCCESSFUL ATTEMPTS WERE MADE TO OBTAIN ADDITIONAL CLINICAL INFORMATION.

Description of Event or Problem · 0

ON (B)(6) 2019, THE FOLLOWING INFORMATION WAS REPORTED TO KCI BY THE NURSE PRACTITIONER WITH PHOTOS OF THE WOUND: THE PATIENT ALLEGED THIRD DEGREE BURNS WERE INCURRED BY THE PREVENA PLUS ¿ INCISION MANAGEMENT SYSTEM IN (B)(6) 2018. ON (B)(6) 2019, THE FOLLOWING INFORMATION WAS REPORTED TO KCI BY NURSE PRACTITIONER: THE PATIENT WAS USING A PREVENA PLUS¿ CUSTOMIZABLE DRESSING. NO ADDITIONAL INFORMATION AVAILABLE. THE PREVENA PLUS¿ CUSTOMIZABLE DRESSING IDENTIFIER HAS NOT BEEN PROVIDED, THEREFORE A DEVICE HISTORY REVIEW COULD NOT BE PERFORMED.

Additional Manufacturer Narrative · 1

DATE OF EVENT: SPECIFIC DATE OF THE EVENT IS UNKNOWN AS THE PATIENT STATED THE OCCURRENCE WAS FROM (B)(6) 2018. THE SPECIFIC DATE WAS NOT PROVIDED. DEVICE EVALUATED BY MFR: DEVICE IDENTIFIERS HAVE NOT BEEN PROVIDED AND THE PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION PROVIDED, IT CANNOT BE DETERMINED THAT THE ALLEGED BLISTERING RESULTING IN AN INFECTION IS RELATED TO THE PREVENA¿ INCISION MANAGEMENT SYSTEM. DEVICE LABELING, AVAILABLE IN PRINT AND ONLINE, STATES: WARNINGS: INFECTION: THE FOLLOWING SYMPTOMS MAY MEAN THAT YOUR INCISION IS INFECTED. CALL YOUR DOCTOR RIGHT AWAY IF YOU: HAVE SWELLING AT THE DRESSING; FEEL FEVERISH; HAVE PUS AT THE DRESSING SITE; FEEL AN INCREASE IN SORENESS AT THE DRESSING; HAVE REDNESS AROUND THE DRESSING; FEEL ITCHING AT THE DRESSING; FEEL WARMTH AT THE DRESSING; HAVE A BAD ODOR AT THE DRESSING.

Description of Event or Problem · 1

ON 19-JUN-2019, THE FOLLOWING INFORMATION WAS REPORTED TO KCI BY THE NURSE PRACTITIONER WITH PHOTOS OF THE WOUND: THE PATIENT ALLEGED THIRD DEGREE BURNS WERE INCURRED BY THE PREVENA ¿ INCISION MANAGEMENT SYSTEM IN (B)(6) 2018. ON 20-JUN-2019, KCI REVIEWED THE IMAGES PROVIDED WHICH EXHIBITED A SUTURED WOUND THAT HAS TWO AREAS THAT HAVE THE EPIDERMAL LAYER OF THE SKIN REMOVED. ONE OF THE AREAS APPEARS TO HAVE SLOUGH AND BLISTERING IS OBSERVED. REDNESS AND SWELLING ARE OBSERVED IN SOME AREAS OF THE PERIWOUND AND ON THE INCISION LINE. ON 11-JUL-2019, THE FOLLOWING INFORMATION WAS REPORTED TO KCI BY THE NURSE PRACTITIONER: THE PATIENT INCURRED BLISTERS WHICH ALLEGEDLY RESULTED IN A STAPHYLOCOCCUS INFECTION THAT REQUIRED ANTIBIOTIC THERAPY. NO FURTHER INFORMATION IS AVAILABLE. THE DEVICE IDENTIFIERS HAVE NOT BEEN PROVIDED AND THE PRODUCT WAS NOT RETURNED, THEREFORE A DEVICE EVALUATION AND A DEVICE HISTORY REVIEW COULD NOT BE PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
601431 PREVENA PLUS¿ INCISION MANAGEMENT SYSTEM OMP OMP KINETIC CONCEPTS, INC. WNDPPL ASKU

Patients

Seq Age Sex Outcome Treatment
1 Other| R