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 2019-01-15 for BIOGLUE SYRINGE 5-PACK, 2ML BG3502-5-G manufactured by Cryolife, Inc..
[133069264]
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Patient Sequence No: 1, Text Type: N, H10
[133069505]
According to an email on 12/20/2018: "in neurosurgery, a patient had a surgery and 5 months after the scar started to leak. They said [the product] was still not resorbed but that there was no risk of inflammation as per the tests. They had to re-operate the patient to take out excess/fibres of [the product]. "
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1063481-2019-00002 |
| MDR Report Key | 8248181 |
| Report Source | FOREIGN,USER FACILITY |
| Date Received | 2019-01-15 |
| Date of Report | 2019-02-21 |
| Date Facility Aware | 2018-12-20 |
| Date Mfgr Received | 2018-12-20 |
| Date Added to Maude | 2019-01-15 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | ROCHELLE MANEY |
| Manufacturer Street | 1655 ROBERTS BLVD. NW |
| Manufacturer City | KENNESAW GA 30144 |
| Manufacturer Country | US |
| Manufacturer Postal | 30144 |
| Manufacturer Phone | 7704193355 |
| Manufacturer G1 | CRYOLIFE, INC. |
| Manufacturer Street | 1655 ROBERTS BLVD. NW |
| Manufacturer City | KENNESAW GA 30144 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 30144 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BIOGLUE SYRINGE 5-PACK, 2ML |
| Generic Name | GLUE,SURGICAL,ARTERIES |
| Product Code | MUQ |
| Date Received | 2019-01-15 |
| Model Number | BG3502-5-G |
| Lot Number | 17MGW005 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | CRYOLIFE, INC. |
| Manufacturer Address | 1655 ROBERTS BLVD. NW KENNESAW GA 30144 US 30144 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Other | 2019-01-15 |