MAUDE MDR 8470208

MDR report key
8470208
Report number
1000317571-2019-00044
Event key
0
Event type
3
Date received
2019-04-01
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. JEANETTE JOHNSON
Address
7900 TRIAD CENTER DRIVE SUITE 400 GREENSBORO NC 27409 US
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1#N/ANOT APPLICABLECONVATEC LTDNAC4208248H03070N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-04-010

Event Narratives#

N

Patient 1

(B)(6). BASED ON THE AVAILABLE INFORMATION, THIS EVENT IS DEEMED TO BE A REPORTABLE MALFUNCTION. A BATCH RECORD REVIEW INDICATES NO DISCREPANCIES. MACHINE LOGS HAVE BEEN CHECKED AND NO DISCREPANCIES WERE FOUND. PREVENTIVE MAINTENANCE (PM) LOGS WERE CHECKED AND ALL PMS WERE COMPLETED WITH NO ISSUES FOUND. LOT # 8H03070 WAS STERILIZED UNDER LOT 1216022711 AND RELEASED ON REVIEW OF RESULTS OF STERILIZATION. ALL OF THE RESULTS WERE WITHIN SPECIFICATION AND PRODUCTS WERE RELEASED IN COMPLIANCE WITH STANDARD OPERATING PROCEDURES. THE PRODUCTION PROCESS, IN PROCESS TESTING AND PACKAGING OF PRODUCTS WAS RUN IN ACCORDANCE WITH PROCESS INSTRUCTIONS FOR MACHINE DOYEN 3. VISUAL INSPECTION WAS PERFORMED IN ACCORDANCE WITH TEST METHODS AND WAS COMPLETED AT THE BEGINNING OF THE ORDER AND EVERY HOUR FOLLOWING UNTIL THE ORDER WAS COMPLETE. NO NONCONFORMITY WAS RAISED DURING THE MANUFACTURING PROCESS OF LOT 8H03070. THIS IS THE ONLY COMPLAINT FOR THE AFFECTED LOT REGISTERED WITHIN TW8.7. TWO (2) PHOTOGRAPHS HAVE BEEN RECEIVED FOR THIS ISSUE AND HAVE BEEN EVALUATED IN ACCORDANCE WITH WORK INSTRUCTIONS. THE PHOTOGRAPHS CONFIRM THE COMPLAINT ISSUE, THE LOT NUMBER AND THAT THIS IS THE PRODUCT EXPECTED. THE PHOTOGRAPHS SHOW DARK SPECKS ON THE DRESSINGS HOWEVER AS THE DRESSINGS ARE NO BEING RETURNED IT CANNOT BE CONFIRMED WHAT THE FOREIGN MATTER IS. OPERATORS WILL BE MADE AWARE OF THE COMPLAINT ISSUE. THIS ISSUE WILL BE MONITORED THROUGH THE POST MARKET PRODUCT MONITORING REVIEW PROCESS. TO DATE NO ADDITIONAL INFORMATION HAS BEEN RECEIVED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED. (B)(4).

D

Patient 1

IT WAS REPORTED "ONE OF THE CORNER IS COVERED IN DOTS OF MOLD. THE POCKET WAS SEALED PROPERLY TOO." PHOTOS DEPICTING THE REPORTED COMPLAINT ISSUE WERE PROVIDED BY THE COMPLAINANT.