MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2017-09-05 for manufactured by .

Event Text Entries

[84718729] Brand name: ostomy-unknown wafer, common device name: protector, ostomy, product code: exe, manufacturer: convatec inc. (b)(4). Model#: ostomy-unknown wafer. Based on the available information, this event is deemed to be a serious injury. No lot number or product evaluation sample is available. A detailed investigation or batch review cannot be conducted. Therefore, this evaluation will be closed and will be monitored through our post market product monitoring review process. Additional information has been requested but nothing has been received to date. Should additional information become available, a follow-up report will be submitted. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[84718730] It was reported by the end user that she was provided convatec cut-to-fit wafers by her home care nurse sometime in 2006 or 2007 and when she cut them, the cut edges felt sharp. The end user reports she had a small amount of bleeding from her stoma and thinks it was caused by the sharp edge. The end user changed out the wafers to larger moldable ones and the bleeding resolved and has not recurred. No further harm was reported by the patient. No pictures were available and no further details have been provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1049092-2017-00047
MDR Report Key6842086
Report SourceCONSUMER
Date Received2017-09-05
Date Mfgr Received2017-08-18
Date Added to Maude2017-09-05
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
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Product CodeEZS
Date Received2017-09-05
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-09-05

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