FDA Adverse Event Other Summary report: N

CONTOUR THREAD

MDR report key: 975248 · Received January 3, 2008

Report

Report Number
2522801-2007-00012
Event Type
Other
Date Received
January 3, 2008
Date of Event
March 9, 2006
Report Date
January 2, 2008
Manufacturer
SURGICAL SPECIALTIES CORP. (DBA ANGIOTECH)
Product Code
GAW
PMA / PMN Number
K050548
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PATIENT REPORTING PROBLEM WOULD NOT SUPPLY HER PHYSICIAN'S NAME TO SURGICAL SPECIALTIES CORPORATION (DBA ANGIOTECH), THEREFORE, WE WERE NOT ABLE TO VERIFY THE TRAINING OF THE PHYSICIAN OR CHECK THE DEVICE HISTORY RECORDS FOR THE PRODUCT USED ON THIS PATIENT.

Description of Event or Problem · 1

PT REPORTED EXPERIENCING PAIN, INFECTION, BAD SCARRING AND COMPLICATIONS SECONDARY TO SUPERFICIAL PLACEMENT OF PRODUCT. NOT ABLE TO VERIFY ANY OF THE ABOVE WITH INSERTING PHYSICIAN AS THE PT DOES NOT WISH TO SUPPLY THAT INFO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTOUR THREAD CONTOUR THREAD GAW SURGICAL SPECIALTIES CORP. (DBA ANGIOTECH) UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK