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Catalog Number LXMC15 |
Device Problems
Device Appears to Trigger Rejection (1524); Adverse Event Without Identified Device or Use Problem (2993)
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Patient Problems
Dysphagia/ Odynophagia (1815); Cramp(s) /Muscle Spasm(s) (4521)
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Event Date 01/01/2023 |
Event Type
malfunction
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Manufacturer Narrative
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(b)(4).Date sent: 7/25/2023.B3: only event year known: 2023.Lot number was received and dhr is pending review.When the review is completed, a supplemental medwatch will be sent with a summary of the evaluation.Additional information received: if event is serious and device related, according to the protocol and instructions for use, in the opinion of the investigator, is the adverse event expected/anticipated? : no => blank.If event is serious and device related, according to the protocol and instructions for use, in the opinion of the investigator, is the adverse event expected/anticipated? : blank => n/a.Outcome : blank => recovered/resolved.Relationship to study procedure : blank => possible.End date : blank => (b)(6) 2023.Updated log line: 2 relationship to study procedure : not related => possible.Drug therapy: yes.Relationship to primary study procedure: possible.This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by ethicon, or its employees that the report constitutes an admission that the product, ethicon, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.
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Event Description
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It was reported via clinical trial patient (b)(6) experience, esophageal spasms, dysphagia.Relationship to study device: not related.
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Manufacturer Narrative
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(b)(4).Date sent: 8/25/2023.Investigation summary : an analysis of the product could not be performed since a physical sample was not received for evaluation.As part of our company quality system process, all devices are manufactured, inspected, and distributed to approved specifications.However, if the product is received at a later date, the investigation will be updated as applicable.A manufacturing record evaluation was performed for the finished device lot number 29032, and no related nonconformances were identified.
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Search Alerts/Recalls
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