MAUDE MDR 2348984

MDR report key
2348984
Report number
1225520-2011-00003
Event key
0
Event type
3
Date of event
2011-08-05
Date received
2011-11-16
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
116
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
G. MURACA
Address
40 GRISSOM RD SUITE 100 PLYMOUTH MA 02360 US
Phone
508-508-5087
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HARVEST SMARTPREP2 CENTRIFUGE SYSTEM, APC60PLATELET CONCENTRATION SYSTEMHARVEST TECHNOLOGIES CORPORATIONJQCAPC60APC60APC60-0101R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12011-11-1601. R

Event Narratives#

D

Patient 1

(B)(6), REPORTED THAT PATIENT HAD A SINUS AUGMENTATION PROCEDURE DUE TO INADEQUATE VERTICAL HEIGHT FOR FUTURE DENTAL IMPLANT PROCEDURE AND DEVELOPED AN INFECTION.

N

Patient 1

THE PATIENT WAS PLACED ON PROPHYLACTIC ANTIBIOTICS THE DAY BEFORE SURGERY AND CONTINUED TO TAKE THEM DURING THE COURSE OF THE INFECTION. ANTIBIOTICS WERE CHANGED DURING THE COURSE OF THE INFECTION AND A DRAIN WAS PLACED. ANTIBIOTIC THERAPY: AMOXICILLIN DAY PRIOR TO SURGERY, (B)(6) 2011 AUGMENTIN/FLAGYL, (B)(6) 2011 EXTENDED FLAGYL COURSE, (B)(6) 2011 EXTENDED AUGMENTIN COURSE. THERE WAS NO EVIDENCE AND CONTINUES TO BE NO EVIDENCE OF INFECTION ASSOCIATED WITH A ROOT CANAL OR ANY ABSCESS. THE SINUS MEMBRANE WAS INTACT AND NOT COMPROMISED. PATIENT HAD UNREMARKABLE MEDICAL HISTORY. HOSPITALIZATION WAS NOT NECESSARY. THERE WAS NO PERMANENT INJURY OR DISABILITY. INFECTION HAS RESOLVED. PATIENT IS DOING WELL TODAY AND WILL BE GETTING AN IMPLANT IN THE FUTURE.