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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 Skin Infection (4544)
Event Date 11/01/2023
Event Type  Injury  
Manufacturer Narrative
Reference record (b)(4).Catalog number in d4 is the similar us list number; the international list number is unknown.The device manufacturer and lot number of the device involved in this complaint was not provided.Therefore, it is unknown if the device involved was abbvie branded tubing.Conservatively, abbvie has chosen to report this complaint due to the potential that the device involved could have been abbvie branded tubing.The device involved in the event remained implanted in the patient and was not returned; 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 the united kingdom underwent a procedure for the placement of percutaneous endoscopic gastrostomy (peg) tube.In (b)(6) 2023 the patient stoma site was red with oozing.A culture was done and the patient was prescribed an unspecified antibiotic and topical cream.At the time of report, the stoma site was looking better.
 
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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 Key18344391
MDR Text Key330804723
Report Number3010757606-2023-00827
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 Other,Foreign,Consumer,Health Professional
Reporter Occupation Physician
Remedial Action Other
Type of Report Initial
Report Date 12/08/2023
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 Catalogue Number062910
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 11/09/2023
Initial Date FDA Received12/18/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
J TUBE, UNKNOWN MANUFACTURER
Patient Outcome(s) Required Intervention;
Patient Age67 YR
Patient SexFemale
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