PROGEL PLUERAL AIR LEAK SEALANT PGPS002

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2016-12-22 for PROGEL PLUERAL AIR LEAK SEALANT PGPS002 manufactured by Davol Inc., Sub. C.r. Bard, Inc..

Event Text Entries

[63098378] The progel was used to treat the patient and there was no immediate post-op complications reported and the patient was released in good condition. Progel? Pleural air leak sealant is a single use device intended for application to visceral pleura after standard visceral pleural closure with, for example, sutures or staples, of visible air leaks incurred during resection of lung parenchyma. Progel will support seal strength during initial postoperative period. A review of the manufacturing records for this product lot was performed and no anomalies were found. Based on the information provided the source of the air leak that presented 14 days post-op cannot be determined. At this time no definitive conclusions can be made. The information provided by bard represents all of the known information at this time. Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bard.
Patient Sequence No: 1, Text Type: N, H10


[63098379] As reported on (b)(6) 2016 the patient underwent lobectomy that included use of progel sealant over the primary closure. On (b)(6) 2016 the patient was released home with no issues. On (b)(6) 2016 the patient came back into doctors office with delayed air leak. Patient presenting with pneumothorax on x-ray. A chest tube was placed in the or and the patient was managed very conservatively. On (b)(6) 2016 the chest tube was removed and on (b)(6) 2016 the patient was discharged and is reportedly doing well.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1213643-2016-00583
MDR Report Key6198522
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2016-12-22
Date of Report2018-12-26
Date of Event2016-11-28
Date Mfgr Received2018-12-21
Device Manufacturer Date2016-10-20
Date Added to Maude2016-12-22
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 FDA3
Event Location3
Manufacturer ContactANNA SMITH
Manufacturer Street100 CROSSINGS BLVD.
Manufacturer CityWARWICK RI 02886
Manufacturer CountryUS
Manufacturer Postal02886
Manufacturer Phone4018258449
Manufacturer G1NEOMEND INC -2953195
Manufacturer Street60 TECHNOLOGY DRIVE
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal Code92618
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePROGEL PLUERAL AIR LEAK SEALANT
Generic NameSEALANT, POLYMERIZING
Product CodeNBE
Date Received2016-12-22
Model NumberNA
Catalog NumberPGPS002
Lot Number161019-001
Device Expiration Date2017-12-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDAVOL INC., SUB. C.R. BARD, INC.
Manufacturer Address100 CROSSINGS BLVD. WARWICK RI 02886 US 02886


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2016-12-22

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