ETHIBOND EXTRA & EXCEL POLYESTER SUTURE MX833

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2012-09-19 for ETHIBOND EXTRA & EXCEL POLYESTER SUTURE MX833 manufactured by Ethicon, Inc..

Event Text Entries

[2976513] It was reported that a patient underwent a spinal cord stimulator implant procedure on (b)(6) 2012 and suture was used to anchor the lead. The lead was migrating and the surgeon discovered that the non-absorbable suture had absorbed. There was no remnant of suture left at the anchor. A different type of suture was used in a follow-up surgery to correct the problem. Additional information was requested.
Patient Sequence No: 1, Text Type: D, B5


[10181772] (b)(4). Suture absorbed. Conclusion: the product upon which this medwatch is based is anticipated. Once the product is received, any further information derived from the evaluation will be submitted in a supplemental 3500a form. In addition, a review of the batch manufacturing records was conducted and the batch met all finished goods release criteria.
Patient Sequence No: 1, Text Type: N, H10


[10260337] Conclusion: one representative samples from the same lot number as the actual device were returned for evaluation. No actual returned used suture or explants were provided, so a complete examination was not possible. It could not be determined what suture was actually used in the procedure.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2210968-2012-05458
MDR Report Key2751232
Report Source05,06
Date Received2012-09-19
Date of Report2012-08-31
Date Mfgr Received2012-11-28
Date Added to Maude2012-09-19
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 Location3
Manufacturer ContactMR. DANIEL LAMONT
Manufacturer StreetROUTE 22 WEST PO BOX 151
Manufacturer CitySOMERVILLE NJ 08876
Manufacturer CountryUS
Manufacturer Postal08876
Manufacturer Phone9082182708
Manufacturer G1ETHICON, INC. - JUAREZ
Manufacturer StreetAVE DE LAS TORRES #7125 COL SALVARCAR
Manufacturer CityJUAREZ 32580
Manufacturer CountryMX
Manufacturer Postal Code32580
Single Use3
Remedial ActionOT
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameETHIBOND EXTRA & EXCEL POLYESTER SUTURE
Generic NameSUTURE, NON-ABSORBABLE
Product CodeGAS
Date Received2012-09-19
Returned To Mfg2012-09-13
Model NumberNA
Catalog NumberMX833
Lot NumberDBM197
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerETHICON, INC.
Manufacturer AddressROUTE 22 WEST PO BOX 151 SOMERVILLE NJ 08876 US 08876


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2012-09-19

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