BIOGLUE - UNKNOWN CONFIGURATION BIOGLUE UNKNOWN

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,user facility report with the FDA on 2018-12-06 for BIOGLUE - UNKNOWN CONFIGURATION BIOGLUE UNKNOWN manufactured by Cryolife, Inc..

Event Text Entries

[129498600] This investigation is currently ongoing. Any additional information will be provided in the follow-up report.
Patient Sequence No: 1, Text Type: N, H10


[129498601] An article was received on (b)(6) 2018 pertaining to patients who had re-operation in which the product may have been used. Please reference "repeat surgical intervention after aortic repair for acute stanford type a dissection" article for more details pertaining to the reported event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1063481-2018-00051
MDR Report Key8138443
Report SourceFOREIGN,USER FACILITY
Date Received2018-12-06
Date of Report2019-01-28
Date Facility Aware2018-11-08
Date Mfgr Received2018-11-08
Date Added to Maude2018-12-06
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 ContactROCHELLE MANEY
Manufacturer Street1655 ROBERTS BLVD. NW
Manufacturer CityKENNESAW GA 30144
Manufacturer CountryUS
Manufacturer Postal30144
Manufacturer Phone7704193355
Manufacturer G1CRYOLIFE, INC.
Manufacturer Street1655 ROBERTS BLVD. NW
Manufacturer CityKENNESAW GA 30144
Manufacturer CountryUS
Manufacturer Postal Code30144
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBIOGLUE - UNKNOWN CONFIGURATION
Generic NameGLUE,SURGICAL,ARTERIES
Product CodeMUQ
Date Received2018-12-06
Model NumberBIOGLUE UNKNOWN
Lot NumberUNKNOWN
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCRYOLIFE, INC.
Manufacturer Address1655 ROBERTS BLVD. NW KENNESAW GA 30144 US 30144


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-12-06

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