MAUDE MDR 2182827

MDR report key
2182827
Report number
3006760724-2011-00011
Event key
0
Event type
3
Date of event
2010-04-26
Date received
2011-07-28
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
MR TERRY MCMAHON
Address
970 LAKE CARILLON DRIVE SUITE 110 ST. PETERSBURG FL 33716 US
Phone
727-727-7273
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1UNI-SOLVE WIPESSOLVENT, ADHESIVE TAPESMITH & NEPHEW WOUND MANAGEMENTKOX402300402300N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12011-07-2801. D

Event Narratives#

D

Patient 1

THIS (B)(4) COMPLAINT WAS RECEIVED POST SMITH & NEPHEW'S REMEDIAL ACTION (VOLUNTARY RECALL) TO PREVENT AN UNREASONABLE RISK OF SUBSTANTIAL HARM TO THE PUBLIC HEALTH ((B)(4)). ULCER THINGS APPEARED THEN WENT AWAY AFTER (B)(6) UNDER DOCTORS CARE. PATIENT PLACED ON BAG IN 1998, AND DEVELOPED URINARY TRACT INFECTION, AND SUBSEQUENTLY WENT SEPTIC. PATIENT DIED ON OR AROUND (B)(6) 2010.

N

Patient 1

ACTIVE INVESTIGATION IS CURRENTLY IN PROGRESS BY SMITH & NEPHEW, AS WELL AS A REVIEW OF THE INCIDENT DETAILS BY OUR MEDICAL ADVISOR. INVESTIGATION RESULTS WILL BE PROVIDED IN A SUPPLEMENT REPORT ONCE A THOROUGH INVESTIGATION HAS BEEN COMPLETED. (B)(4).

N

Patient 1

THE CUSTOMER DID NOT RETURN ANY PRODUCT. WE WERE UNABLE TO CONFIRM THE COMPLAINT SINCE THE LOT NUMBER WAS NOT PROVIDED AND NO SAMPLES WERE TESTED. S&N HAS MANUFACTURED THIS PRODUCT AT 2 DIFFERENT LOCATIONS AND SO WITHOUT THE LOT NUMBER, THE PRODUCTION RECORDS CANNOT BE REVIEWED AND FURTHER INVESTIGATION CANNOT BE PERFORMED. CONTROL SAMPLES (FROM RETAINS STOCK) OF SOME LOT OF UNI-SOLVE WIPES MANUFACTURED BY TRIAD WERE ANALYZED BY AN INDEPENDENT TEST LABORATORY AND MET FINISHED PRODUCT SPECIFICATIONS WITH NO EVIDENCE OF MICROBIAL CONTAMINATION FOUND. AN INDEPENDENT MEDICAL REVIEW OF THIS EVENT INDICATED THAT THERE IS NO MEDICAL EVIDENCE TO SUPPORT ANY RELATIONSHIP BETWEEN THE USE OF UNISOLVE WIPES, AND THE PATIENT'S SYMPTOMS AND/OR SUBSEQUENT DEATH.