MAUDE Adverse Event Report: SMITH & NEPHEW MEDICAL LTD. ALLEVYN LIFE SACRUM (LARGE) PACK OF 10; DRESSING, WOUND, OCCLUSIVE

Model Number	66801307
Medical Device Problem Code	Loss of or Failure to Bond (1068)
Health Effect - Clinical Code	No Consequences Or Impact To Patient (2199)
Date of Event	09/21/2020
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that the allevyn life sacrum 21.6cm x 23cm pack of 10, the dressing's silicone is coming off in large sections onto the backing and onto the patient.Because of this, they are unable to follow the prevention protocol because the dressing barely lasts one shift.Silicone is everywhere, and not adhering when lifted for assessment.
Additional Manufacturer Narrative
We have now concluded our investigation for the complaint received.A review of the associated batch manufacturing records did not identify any issue at the point of manufacture which may have caused or contributed to the issue highlighted by the complainant.In addition it can be confirmed that all finished product specification testing was satisfied at the point of release.A complaints history review was carried out using the lot and part numbers provided, there have been no further complaints reported with this failure mode in the past three years.The devices were intended for use in treatment, according to the description of complaint, the complaint issue is silicone offsetting.This confirmed a relationship between the event and the device.The wound contact surface of the allevyn life is coated with a gentle silicone adhesive layer that ensures non-traumatic removal at dressing changes.The silicone adhesive will feel sticky when compared to an acrylic adhesive and is specially designed to be very soft and gentle, but can soften further, particularly at higher temperatures.This is an inherent characteristic of all of the silicone adhesives and gives them their soft / gentle properties.It is possible the silicone adhesive on the wound contact layer has problem, the potential cause of this failure mode could have been due to the raw materials issue.An ongoing internal project is being carried out into this failure mode, therefore no further actions are deemed necessary into these specific complaints.Smith and nephew acknowledge customer concern and are continually investigating ways to develop and improve our products.We will continue to monitor for any adverse trends relating to this product range.
Additional Manufacturer Narrative
H3, h6: we have now concluded our investigation for the complaint received.The device intended to be used in treatment was returned for evaluation, establishing a relationship with the reported event.Visual inspection confirmed silicone remained on the carrier, functional evaluation confirmed reduced adherence.The root cause has been identified as raw material issue.The manufacturing records show no evidence that the product did not meet specification at the time of manufacture.The complaint history file contains further instances of the reported events.An ongoing internal project has been carried out into the reported failure mode, therefore no further actions are deemed necessary into this specific complaint.Smith and nephew acknowledge customer concern and are continually investigating ways to develop and improve our products.We will continue to monitor for any adverse trends relating to this product range.

• Brand Name: ALLEVYN LIFE SACRUM (LARGE) PACK OF 10
• Common Device Name: DRESSING, WOUND, OCCLUSIVE
• Manufacturer (Section D): SMITH & NEPHEW MEDICAL LTD.; 101 hessle road; hull east riding of yorkshire HU3 2 BN; UK HU3 2BN
• MDR Report Key: 10679127
• Report Number: 8043484-2020-03199
• Device Sequence Number: 19568790
• Product Code: NAD
• UDI-Device Identifier: 05000223481452
• UDI-Public: 05000223481452
• Combination Product (Y/N): N
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: health professional,user faci
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 05/13/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Model Number: 66801307
• Device Catalogue Number: 66801307
• Device Lot Number: 202012
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 04/08/2021
• Initial Date Received by Manufacturer: 09/21/2020
• Supplement Date Received by Manufacturer: 11/13/2020; 05/12/2021
• Initial Report FDA Received Date: 10/14/2020
• Supplement Report FDA Received Date: 11/20/2020; 05/13/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1