MAUDE MDR 2216608

MDR report key
2216608
Report number
3006760724-2011-00019
Event key
0
Event type
3
Date of event
2011-07-27
Date received
2011-08-18
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 MANAGEMENTKOX4023000H185R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12011-08-1801. H

Event Narratives#

N

Patient 1

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.

N

Patient 1

ACTIVE INVESTIGATION IN PROGRESS; RESULTS OF INVESTIGATION WILL BE PROVIDED IN SUPPLEMENT REPORT. (B)(4).

D

Patient 1

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