MAUDE Adverse Event Report: CONVATEC DOMINICAN REPUBLIC INC L3W0600 - AQUACEL; DRESSING,WOUND,HYDROPHILIC

Model Number 412020

Device Problem Patient-Device Incompatibility (2682)

Patient Problem Erythema (1840)

Event Date 07/19/2022

Event Type  malfunction  

Event Description

The nurse reported that dressing was applied to wound in the event morning and due to heavy exudate, dressing capacity was full.It was removed the same evening and found that the dressing adhesive was stuck to end user skin and as a result of this, considerable redness in the peri-wound area was reported.The end user has no underlying diseases or regular medications and no allergies.Post-operative medications include panadol (paracetamol), vimomo (naproxen/esomeprazole) and tarqinic (oxycodone).A photograph depicting the issue was received from the complainant.

Manufacturer Narrative

Complainant city: (b)(6).Complainant country: (b)(6).Based on the available information, this event is deemed to be a reportable malfunction.To date no additional information has been received.Should additional information become available, a follow-up report will be submitted.

Manufacturer Narrative

Additional information - this emdr is being submitted to include the below: h6: investigation results under imdrf cause investigation code, imdrf investigation findings, imdrf cause conclusions.Photograph, video and/or physical sample evaluation: there is a photograph associated with this case and in this, the reported defect can be seen.No unused return sample was expected.Batch record revision results: lot 1e00766 was manufactured on 11/may/2021, in scd line, with a total of (b)(4) market units (mkus).The complaint investigator performed a batch record review on 25/sep/2023, to verify if all the applicable procedures were followed and no issues were found; all the components for assembly were correct per bill of materials (bom) and all the tooling information documented was also correct, system application product (sap) material id 1257954 and manufacturing order (b)(4).The production process, in-process control, testing results and packaging of products was run according to the applicable process instruction.Review of the batch records showed that all relevant tests required during the manufacturing process and final product release had been fulfilled and met the requirements.No discrepancy related to this issue were found within the documentation.Historical complaints review: on 25/sep/2023, complaint investigator ran a query in database from 01/jan/2022 to 25/sep/2023 in order to verify the complaints reported for the lot number 1e00766 for the malfunction code ¿dressing/ribbon/gel handles insufficient wound exudate or does not retain absorbed wound exudate¿ and as result, no additional complaints were found.Historical nonconformance review: on 25/sep/2023, complaint investigator ran a query in database looking for any in process nonconformance /corrective action/preventive action (capa (s) associated to the malfunction code ¿dressing/ribbon/gel handles insufficient wound exudate or does not retain absorbed wound exudate¿ for the lot number 1e00766 and as result, no nonconformance / corrective action / preventive actions (capa (s) for this malfunction code were generated during the manufacturing process of the referenced lot.Defect rate analysis: there has only been 1 defective part confirmed to date from a lot size of 19,240 products.This represents a defect rate of only 0.005% which is well within an appropriate acceptable quality level (aql) for heavy exudate - difficult to remove issues which should be 0.25% based on our standard operating procedure (sop).In addition, all of the in-process testing on this lot did not find an adhesive issues, which confirms that the lot is unlikely to breach an acceptable quality level (aql) of 0.25.This issue certainly appears to be an isolated incident, but more importantly to date, it is well within our accepted acceptable quality level (aql) level for this type of failure mode or defect.Conclusions: there is a photograph associated with this case and in this, the reported defect can be seen.No unused return sample was expected.The review of the batch record showed that all relevant tests required during the manufacturing process and final product release had been fulfilled and met the requirements.No nonconformity has been registered during the manufacturing process of the affected lot for the malfunction code ¿dressing/ribbon/gel handles insufficient wound exudate or does not retain absorbed wound exudate¿.No additional complaints were reported for lot affected related to the malfunction code ¿dressing/ribbon/gel handles insufficient wound exudate or does not retain absorbed wound exudate¿.Based on this, no negative trend was identified.This issue will be monitored through the post market product monitoring review process.To date no additional information has been received.Should additional information become available, a follow-up report will be submitted.Fda registration number: reporting site: 1049092.Manufacturing site: 9618003.

Event Description

To date no additional patient or event details have been received.

• Brand Name: L3W0600 - AQUACEL
• Type of Device: DRESSING,WOUND,HYDROPHILIC
• Manufacturer (Section D): CONVATEC DOMINICAN REPUBLIC INC; km 18.5 parque industrial; itabo, s.a. haina; san cristobal 91000 ; DR 91000
• Manufacturer (Section G): CONVATEC DOMINICAN REPUBLIC INC; km 18.5 parque industrial; itabo, s.a. haina; san cristobal 91000 ; DR 91000
• Manufacturer Contact: pamela meadows ; 7815 national service road; suite 600; greensboro, NC ; 3365424679
• MDR Report Key: 15230748
• MDR Text Key: 302870934
• Report Number: 9618003-2022-04694
• Device Sequence Number: 1
• Product Code: NAC
• Combination Product (y/n): N
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional
• Reporter Occupation: Nurse
• Type of Report: Initial,Followup
• Report Date: 07/20/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 08/16/2022
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 05/01/2023
• Device Model Number: 412020
• Device Lot Number: 1E00766
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: Yes
• Date Manufacturer Received: 09/30/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 05/11/2021
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1