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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBVIE - MEDICAL DEVICE CENTER DUODOPA_DUOPA; TUBES, GASTROINTESTINAL (AND ACCESSORIES)

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ABBVIE - MEDICAL DEVICE CENTER DUODOPA_DUOPA; TUBES, GASTROINTESTINAL (AND ACCESSORIES) Back to Search Results
Catalog Number 062910
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Post Operative Wound Infection (2446)
Event Date 07/23/2020
Event Type  Injury  
Manufacturer Narrative
Reference record (b)(4).The device involved in the event remained implanted in the patient; therefore, a return sample evaluation is unable to be performed.Stoma site infection is a known complication of a peg tube placement.If any further relevant information is identified or obtained, a supplemental medwatch will be filed.
 
Event Description
On an unknown date, a patient in (b)(6) underwent a procedure for the placement of percutaneous endoscopic gastrostomy (peg) tube with jejunal (peg-j) tube.Duodopa start date (b)(6) 2020.It was reported (b)(6) 2020 that the patient's stoma site was red, sore and oozing.A swab was taken and awaiting results.Oral antibiotic flucloxacillin 500mgs qds for 7days was prescribed and started.On (b)(6) 2020 it was reported the stoma site infection is improving and patient is still taking antibiotics.
 
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Brand Name
DUODOPA_DUOPA
Type of Device
TUBES, GASTROINTESTINAL (AND ACCESSORIES)
Manufacturer (Section D)
ABBVIE - MEDICAL DEVICE CENTER
1675 lakeside drive
waukegan IL 60085
Manufacturer (Section G)
ABBVIE - MEDICAL DEVICE CENTER
1675 lakeside drive
waukegan IL 60085
Manufacturer Contact
terry ingram
1675 lakeside drive
waukegan, IL 60085
8479385350
MDR Report Key10359323
MDR Text Key201537881
Report Number3010757606-2020-00508
Device Sequence Number1
Product Code KNT
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
K142793
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,health professional,o
Reporter Occupation Nurse
Remedial Action Other
Type of Report Initial
Report Date 07/23/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Expiration Date01/31/2023
Device Catalogue Number062910
Device Lot Number32331119
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 07/23/2020
Initial Date FDA Received08/03/2020
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured08/12/2019
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age61 YR
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