MAUDE MDR 9795061

MDR report key
9795061
Report number
2210968-2020-01780
Event key
0
Event type
3
Date of event
2020-01-01
Date received
2020-03-05
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
KARA DITTY-BOVARD
Address
P.O. BOX 151, ROUTE 22 WEST SOMERVILLE NJ 08876 US
Phone
610-610-6107
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1MERSILK BLACK 6 1.8M NON-NDLSUTURE, NONABSORBABLE, SILKETHICON INC.GAPW199MGK215R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-0501. R

Event Narratives#

N

Patient 1

(B)(4). A MANUFACTURING RECORD EVALUATION WAS PERFORMED FOR THE FINISHED DEVICE MGK215 BATCH NUMBER, AND NO NON-CONFORMANCES WERE IDENTIFIED. ATTEMPTS ARE BEING MADE TO RETRIEVE THE DEVICE. TO DATE THE DEVICE HAS NOT BEEN RETURNED. IF THE DEVICE OR FURTHER DETAILS ARE RECEIVED AT A LATER DATE A SUPPLEMENTAL MEDWATCH WILL BE SENT. THE SINGLE COMPLAINT WAS REPORTED WITH MULTIPLE EVENTS. THERE ARE NO ADDITIONAL DETAILS REGARDING THE ADDITIONAL PATIENT EVENTS. ADDITIONAL INFORMATION WAS REQUESTED AND THE FOLLOWING WAS OBTAINED. IF FURTHER DETAILS ARE RECEIVED AT A LATER DATE A SUPPLEMENTAL MEDWATCH WILL BE SENT. -IN THE CLINIC SUTURE MATERIAL HAD BEEN USED BY THE DEPARTMENT OF TRAUMATOLOGY AND ORTHOPEDICS 2.5-3 MONTHS BEFORE THE APPEARANCE OF ADVERSE EVENTS IN THE DEPARTMENT ON THE PATIENTS WITH RECONSTRUCTIONS ON ALL SUTURED LAYERS IN THE SURGICAL WOUND. THEN THE PATIENTS HAD BEEN DISCHARGED TO HOME. AFTER 2.5-3 MONTHS THEY WERE HOSPITALIZED AGAIN IN THE EMERGENCY SURGICAL DEPARTMENT. ALL AVAILABLE INFORMATION FROM DEPARTMENT OF TRAUMATOLOGY AND ORTHOPEDICS ABOUT PATIENT DATA IS BELOW. PATIENT DATA OF THIS COMPLAINT ((B)(4)): MALE, (B)(6) YEARS OLD, WEIGHT (B)(6), RE-HOSPITALIZATION FOR REMOVAL OF FISTULAS. FISTULAS FORMED ON BOTH FEET AFTER MYOTENDOPLASTY IN 3 MONTHS. FISTULAS WERE EXCISED, THE REMAINS OF THE THREADS WERE REMOVED. THE FOLLOWING INFORMATION WAS REQUESTED BUT UNAVAILABLE: DATE OF THE INITIAL SURGERY. THE DIAGNOSIS AND INDICATION FOR THE INDEX SURGICAL PROCEDURE? IT WAS REPORTED THE ?SURGERY WAS ON THE FOOT AND LIGATURE FISTULA FORMED IN SCAR AREA ON LEFT LEG?. PLEASE CLARIFY: ON WHAT TISSUE AND LOCATION WAS THE SUTURE PLACED? IN WHAT TISSUE/STRUCTURE WAS THE FISTULA LOCATED? WHAT WAS THE TISSUE CONDITION, I.E., NORMAL OR THIN, CALCIFIED, FRAGILE, DISEASED? WHAT WERE THE CURRENT SYMPTOMS FOLLOWING THE INITIAL PROCEDURE? WHAT DATE DID THE PATIENT PRESENT WITH SYMPTOMS? IF SECOND OPERATION WAS PERFORMED, WHAT WAS THE APPEARANCE OF THE SUTURE DURING THE REOPERATION? IF APPLICABLE, WILL PRODUCT BE RETURNED, RETURN DATE, TRACKING INFORMATION. OTHER RELEVANT PATIENT HISTORY/CONCOMITANT MEDICATIONS? DID THE OPERATING SURGEON OBSERVE ANY SUTURE DEFICIENCY OR ANOMALY BEFORE, DURING OR AFTER SUTURE PLACEMENT OR DURING ANY RE-OPERATIONS? DOES THE SURGEON BELIEVE THERE WAS ANY SUTURE DEFICIENCY THAT LEAD TO THE POST-OP COMPLICATIONS? WHAT IS PHYSICIAN?S OPINION AS TO THE ETIOLOGY OF OR CONTRIBUTING FACTORS TO THIS EVENT PATIENT?S CURRENT STATUS? NOTE: EVENTS REPORTED VIA MW # 2210968-2020-01779, 2210968-2020-01780.

D

Patient 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT MYOTENOPLASTY ON THE FOOT ON AN UNKNOWN DATE AND SUTURE WAS USED. THE PATIENT WAS DISCHARGED TO HOME. AFTER THE SURGERY, LIGATURE FISTULA FORMED IN SCAR AREA ON THE LEFT LEG. THE PATIENT UNDERWENT REHOSPITALIZATION FOR REMOVAL OF THE FISTULA. IT WAS REPORTED FISTULAS FORMED ON BOTH FEET IN THREE MONTHS. THE FISTULAS WERE EXCISED AND THE REMAINS OF THE SUTURE WERE REMOVED. NO ADDITIONAL INFORMATION WAS PROVIDED.