UNI-SOLVE WIPES 402300

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 04 report with the FDA on 2011-08-18 for UNI-SOLVE WIPES 402300 manufactured by Smith & Nephew Wound Management.

Event Text Entries

[9575796] The customer sent product samples. We were unable to confirm the complaint. Hence laboratory testing was performed on some of the returned samples of this lot, and control samples (from stock) of additional lots of uni-solve wipes were analyzed by an independent test laboratory and met finished product specifications with no evidence of microbial contamination found. Batch records for the lots indicate all specifications were met at the time of release and no inconsistencies were noted. An independent medical review of this complaint this product has concluded that there was no correlation between the reported symptoms and the use of the s&n wipes.
Patient Sequence No: 1, Text Type: N, H10


[22133155] Active investigation in progress; results of investigation will be provided in supplement report. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[22232552] This unisolved complaint was received post smith & nephew's remedial action (voluntary recall) to prevent an unreasonable risk of substantial harm to the public health (ref. Recall #3006760724-04-06-2011-001r). Patient states she was released from the hospital (b)(6) 2011. Patient admitted on (b)(6) 2011. Patient states she noticed her skin was black and blue. Patient called her physician and was told to go to the hospital. Patient states her blood platelets were down. Platlet number 100. Patient states normal platlet number should be 40,000. Patient states she received an infusion during her hospital stay. Emergency room physician stated patient was diagnosed as having a bacterial infection
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3006760724-2011-00019
MDR Report Key2216608
Report Source04
Date Received2011-08-18
Date of Report2011-07-27
Date of Event2011-07-27
Date Mfgr Received2011-07-27
Date Added to Maude2011-08-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR TERRY MCMAHON
Manufacturer Street970 LAKE CARILLON DRIVE SUITE 110
Manufacturer CityST. PETERSBURG FL 33716
Manufacturer CountryUS
Manufacturer Postal33716
Manufacturer Phone7273993785
Manufacturer G1SMITH & NEPHEW WOUND MANAGEMENT
Manufacturer Street970 LAKE CARILLON DRIVE SUITE 110
Manufacturer CityST. PETERSBURG FL 33716
Manufacturer CountryUS
Manufacturer Postal Code33716
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNI-SOLVE WIPES
Generic NameSOLVENT, ADHESIVE TAPE
Product CodeKOX
Date Received2011-08-18
Model Number402300
Lot Number0H185
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSMITH & NEPHEW WOUND MANAGEMENT
Manufacturer Address970 LAKE CARILLON DRIVE SUITE 110 ST. PETERSBURG FL 33716 US 33716


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization 2011-08-18

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