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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 DUODOPA PEG TUBE
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Skin Infection (4544)
Event Date 03/01/2024
Event Type  Injury  
Manufacturer Narrative
Reference number (b)(4).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 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- j 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 underwent a procedure for the placement of percutaneous endoscopic gastrostomy (peg) tube with jejunal (peg-j) tube.In (b)(6) 2024, the patient experienced an infection at the g-tube site; there was pain in the abdomen which turned out to be an abscess/boil.It opened and drained on its own.The patient was intiailly prescribed an unknown antibiotic that didn't work and was then given doxycycline which cleared the infection.
 
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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 Key19006013
MDR Text Key338936556
Report Number3010757606-2024-000018
Device Sequence Number1
Product Code KNT
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K142793
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Health Professional
Reporter Occupation Pharmacist
Remedial Action Other
Type of Report Initial
Report Date 03/29/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/29/2024
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Catalogue NumberDUODOPA PEG TUBE
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/11/2024
Was Device Evaluated by Manufacturer? No
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
UNKNOWN INTESTINAL TUBE, UNKNOWN LOT#
Patient Outcome(s) Required Intervention;
Patient SexFemale
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