DERMGRAFT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2014-09-05 for DERMGRAFT manufactured by Organogenesis, Inc..

Event Text Entries

[19401816] This mdr is being submitted for patient 2 of 3 for this complaint. On (b)(4) 2014, (b)(4), organogensis tissue regeneration specialist (trs) reported to (b)(6), organogensis medical science liaison (msl), on behalf of the treating physician at the (b)(6), that patients who were treated with dermgraft (dg) applications had suspected infections. Subsequent follow up by (b)(6), on (b)(6) 2014 determined that three (2) suspected infections were observed. Each was accompanied with a foul odor and increased drainage when subjects came in for their one-week follow-up appointments on (b)(6) 2014. Dr (b)(6) was skeptical to continue using this lot as he though it was possible that dg caused the presentation of infections. Each of these patients was treated with one (1) dg for the treatment of diabetic foot ulcers. These units were from dg lot #147049, unit numbers unknown, and expiration date october 10, 2014. Based on the description of the infections and the positive response to antibiotics, the severity of these events may be considered as moderate. This lot was shipped to 280 sites without a single additional complaint. All manufacturing and testing documentation was reviewed and no atypical events were recorded that might explain the infections observed. The negative sterility test results on the retain samples validated that the integrity of the product remained free from microorganisms as it was in the organal release. A potential root cause of the infection could be form a preexisting microbial contamination of the wound bed. Another potential root cause of this event would be if these units were contaminated by a common cause during thawing rinsing or application at the (b)(6) site. Although there is substantial evidence to support that the use of dg is unlikely the cause of infections, relatedness cannot be completely ruled out for these 3 applications.
Patient Sequence No: 1, Text Type: D, B5


[19457638] The three suspected infections were cultured and with positive results. Dr. (b)(6) did not have the results of the culturing to report what organism(s) were identified. All three patients did present with the signs and symptoms of infection. All three patients were given appropriate antibiotics and further dg treatment was delayed. The three patients with the suspected infections returned for a 1 week follow-up and they were all responding well to the antibiotics that were prescribed. Dr. (b)(6)'s plan is to resume dg treatment with each of these patients upon receipt of replacement dg units. The available information for this medical event was reviewed by dr (b)(4), organogenesis inc. On (b)(4) 2014. The infections confirmed via culture at the treating site required intervention as antibiotics were prescribed. From the information provided, it is unclear what caused the signs and symptoms associated with infection or if the microorganisms were already present in the diabetic ulcer pre treatment. Dr (b)(6) reported that 1 week following an antibiotics regimen, that all three patients improved and he stated they "responded well to the antibiotic. "
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2028403-2014-00002
MDR Report Key4098151
Report Source07
Date Received2014-09-05
Date of Report2014-09-05
Date of Event2014-08-07
Date Mfgr Received2014-08-07
Device Manufacturer Date2014-04-01
Date Added to Maude2014-09-19
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 Location0
Manufacturer ContactPATRICK BILBO
Manufacturer Street15 DAN RD.
Manufacturer CityCANTON CA 02021
Manufacturer CountryUS
Manufacturer Postal02021
Manufacturer Phone7814011155
Single Use3
Remedial ActionPM
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameDERMGRAFT
Product CodePFC
Date Received2014-09-05
Lot Number147049
Device Expiration Date2014-10-10
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerORGANOGENESIS, INC.
Manufacturer AddressLA JOLLA CA US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2014-09-05

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