GELFOAM

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-02-07 for GELFOAM manufactured by Pfizer, Inc. (device).

Event Text Entries

[178303116] Event verbatim [preferred term] treatment by absorbable gelatin sponge and microcoil embolization after perforation of the distal coronary artery by guidewire [product use in unapproved indication] , foreign body reaction [foreign body reaction] ,. Case narrative:this is a literature-spontaneous report from internal medicine, (2010), (49(17)) (1871-1874) entitled [foreign body granulomatous change from absorbable gelatin sponge and microcoil embolization after a guidewire-induced perforation in the distal coronary artery]. A contactable other hcp reported for a patient that: we report an autopsy case of treatment by absorbable gelatin sponge and microcoil embolization after perforation of the distal coronary artery by guidewire. Histological examination revealed a foreign body granuloma in the coronary artery with embolization. Foreign body reaction to absorbable gelatin sponge seemed to be stronger than that to the microcoil. Additional information has been requested and will be provided as it becomes available. Company clinical evaluation comment: absorbable gelatin sponge used intravascular is contraindicated, and the reported foreign body granulomatous change was associated it. It was unknown whether the underlying perforation of the distal coronary artery by guidewire was the cause of death, or the foreign body granulomatous change in coronary artery attributed to patient's death. This case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the pfizer product is evaluated as part of pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, ethics committees and investigators, as appropriate. , comment: absorbable gelatin sponge used intravascular is contraindicated, and the reported foreign body granulomatous change was associated it. It was unknown whether the underlying perforation of the distal coronary artery by guidewire was the cause of death, or the foreign body granulomatous change in coronary artery attributed to patient's death. This case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the pfizer product is evaluated as part of pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, ethics committees and investigators, as appropriate.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1810189-2020-00007
MDR Report Key9682357
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-02-07
Date of Report2020-01-27
Date Mfgr Received2020-02-12
Date Added to Maude2020-02-07
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMRS STELLA PIETRAFESA
Manufacturer Street235 E42ND STREET
Manufacturer CityNEW YORK NY 10017
Manufacturer CountryUS
Manufacturer Postal10017
Manufacturer G1PFIZER, INC. (DEVICE)
Manufacturer Street7000 PORTAGE ROAD
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal Code49001
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGELFOAM
Generic NameSPONGE, STERILE; CLASS III
Product CodeLMF
Date Received2020-02-07
OperatorHEALTH PROFESSIONAL
Device Availability*
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerPFIZER, INC. (DEVICE)
Manufacturer Address7000 PORTAGE ROAD KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
101. Death; 2. Other; 3. Required No Informationntervention 2020-02-07

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