EPICEL (CULTURED EPIDERMAL AUTOGRAFTS) GRAFTS UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,07 report with the FDA on 2012-08-21 for EPICEL (CULTURED EPIDERMAL AUTOGRAFTS) GRAFTS UNK manufactured by Genzyme Biosurgery (cambridge).

Event Text Entries

[15506814] Cardiovascular failure [cardiac failure]. Case description: spontaneous report was received on (b)(6) 2012, from a physician (via a company rep) regarding a pt (initials, date of birth, and gender not provided). The pt's medical history was not provided. The pt was grafted with epicel on two occasions, 96 grafts on (b)(6) 2011, and 40 grafts on (b)(6) 2012. On (b)(6) 2012, the pt expired due to cardiovascular failure. The action taken with epicel treatment was not provided. Concomitant medications were not provided. The intensity for the event of cardiovascular failure was not provided. The relationship between epicel and the event of cardiovascular failure was assessed as unrelated by the reporting physician.
Patient Sequence No: 1, Text Type: D, B5


[15622302] Additional info was received on (b)(4) 2012, in the form of qa investigation summary. All sterility and environmental monitoring results for the production of the epicel assemblies for lot ee01572 met acceptance criteria. Qa's review the lot batch records, supporting documentation, and testing results indicate that lot ee01572 met all in-process and release specifications. The benefit-risk relationship of epicel is not affected by this report.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1226230-2012-00004
MDR Report Key2713656
Report Source05,07
Date Received2012-08-21
Date of Report2012-01-31
Date Mfgr Received2012-01-31
Date Added to Maude2012-08-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactJILL ROBINSON R., PH, MBA
Manufacturer Street675 W. KENDALL ST
Manufacturer CityCAMBRIDGE MA 02142
Manufacturer CountryUS
Manufacturer Postal02142
Manufacturer Phone6177689000
Manufacturer G1GENZYME BIOSURGERY (CAMBRIDGE)
Manufacturer Street64 SIDNEY ST.
Manufacturer CityCAMBRIDGE MA 02139
Manufacturer CountryUS
Manufacturer Postal Code02139
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameEPICEL (CULTURED EPIDERMAL AUTOGRAFTS) GRAFTS
Generic NameCULTURED EPIDERMAL AUTOGRAFTS
Product CodeOCE
Date Received2012-08-21
Model NumberUNK
Catalog NumberUNK
Lot NumberEE01572
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerGENZYME BIOSURGERY (CAMBRIDGE)
Manufacturer AddressCAMBRIDGE MA US


Patients

Patient NumberTreatmentOutcomeDate
101. Death 2012-08-21

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