ENDOFORM DERMAL TEMPLATE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-02-26 for ENDOFORM DERMAL TEMPLATE manufactured by Aroa Biosurgery Ltd..

Event Text Entries

[137364747] I have used endoform dermal templates on my chronic leg wounds since 2016. I was in a car accident many years ago and am left with open wounds on my lower legs that must remain sterile. In (b)(6) 2018 i developed a progressive deterioration in and around the wounds while still using this product. An infection began to spread outward, turning yellow and black with thick colored seepage. I was placed on oral antibiotics for a month and now i am on topical antibiotics. The wounds themselves have tripled in size and doctors have been unable to contain the spreading. I have now received a recall for the same products i have been placing on my chronic wounds. Aroa biosurgery ltd. Has issued a statement saying there is a quality control problem with potential pouch seal integrity rendering the product non-sterile, dating back to march 2018. I therefore have been putting non-sterile bandages on my open chronic wounds for months. Frequency? Daily. How was it taken or used? Topical. Why was the person using the product? (such as what condition was it supposed to treat) chronic leg wounds. Therapy duration? 3 year.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5084390
MDR Report Key8371833
Date Received2019-02-26
Date of Report2019-02-23
Date of Event2018-05-01
Date Added to Maude2019-02-26
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag0
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 1

Brand NameENDOFORM DERMAL TEMPLATE
Generic NameDRESSING, WOUND, COLLAGEN
Product CodeKGN
Date Received2019-02-26
Lot NumberEDT-7H06
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerAROA BIOSURGERY LTD.

Device Sequence Number: 2

Brand NameENDOFORM DERMAL TEMPLATE
Generic NameDRESSING, WOUND, COLLAGEN
Product CodeKGN
Date Received2019-02-26
Lot NumberEDT-7L02
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No2
Device Event Key0
ManufacturerARORA BIOSURGERY LTD.


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Deathisabilit 2019-02-26

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