COMPOSITE? EPTFE-COATED FLOWERS DORSAL NASAL N/A EPTFE-FDI-3.5

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2017-08-25 for COMPOSITE? EPTFE-COATED FLOWERS DORSAL NASAL N/A EPTFE-FDI-3.5 manufactured by Implantech Associates, Inc..

Event Text Entries

[83648351] Evaluation summary: method: the actual device was not evaluated, however implantech reviewed sterilization records, manufacturing records, and product labeling. Results: no failure was detected. Conclusion: the possibility of infection is a known, inherent risk associated with implant surgery.
Patient Sequence No: 1, Text Type: N, H10


[83648352] Complainant reported implantech nasal implant was explanted a little more than 4 months post-operatively due to infection. Patient reported soreness, redness and swelling about 6 weeks post-operatively, but no culture could be taken at that time. Symptoms worsened and a culture taken (b)(6) 2017 identified staph. Aureus. Multiple courses of antibiotics (clindamycin p. O. , augmentin p. O. ) were prescribed. Eventually, they chose to explant the device without replacement.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2028924-2017-00005
MDR Report Key6820513
Report SourceHEALTH PROFESSIONAL
Date Received2017-08-25
Date of Report2017-08-25
Date of Event2017-08-08
Date Mfgr Received2017-08-08
Device Manufacturer Date2012-02-16
Date Added to Maude2017-08-25
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 ContactMR. CRAIG ARTHUR
Manufacturer Street6025 NICOLLE STREET SUITE B
Manufacturer CityVENTURA CA 93003
Manufacturer CountryUS
Manufacturer Postal93003
Manufacturer Phone8053399415
Manufacturer G1IMPLANTECH ASSOCIATES, INC.
Manufacturer Street6025 NICOLLE STREET, SUITE B
Manufacturer CityVENTURA CA 93003
Manufacturer CountryUS
Manufacturer Postal Code93003
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCOMPOSITE? EPTFE-COATED FLOWERS DORSAL NASAL
Generic NameNASAL IMPLANT
Product CodeLZK
Date Received2017-08-25
Model NumberN/A
Catalog NumberEPTFE-FDI-3.5
Lot Number843567
Device Expiration Date2017-02-15
OperatorPHYSICIAN
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerIMPLANTECH ASSOCIATES, INC.
Manufacturer Address6025 NICOLLE STREET, SUITE B VENTURA CA 93003 US 93003


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-08-25

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