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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CONVATEC LTD AQUACEL FOAM; DRESSING,WOUND,HYDROPHILIC

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CONVATEC LTD AQUACEL FOAM; DRESSING,WOUND,HYDROPHILIC Back to Search Results
Model Number 420635
Device Problems Delivered as Unsterile Product (1421); Contamination /Decontamination Problem (2895); Device Contaminated During Manufacture or Shipping (2969)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
Name of retailer: medfirst.Complainant street address: (b)(6).Complainant city: (b)(6).Complainant state/province: (b)(6).Complainant postal code: (b)(6).Complainant phone number:(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.Fda registration number (b)(4).
 
Event Description
It was reported that hairs were found inside the primary packaging.The product was not used by patient.The photographs depicting the issue were received from the complainant.
 
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.A batch record review was completed and no discrepancies were found.All in-process stat sample quality checks were satisfactory.Aquacel foam n/adh 15x15(1x5) nai was manufactured under system application product (sap) code 1703996 and manufacturing lot number 1c00248 on 03 march 2021.Lot # 1c00248 was sterilised under order identification 2841865 and released on review of results of sterilisation provided by sterilisation company sterigenics.All of the results were within specification and products were released.No nonconformity was identified during the manufacturing process of lot 1c00248.This is the only complaint for the affected lot registered within database.3 photographs were received for this issue and has been evaluated in accordance with work instruction (wi).The photograph confirmed the expected product and the complaint issue where foreign matter (hair) can be seen on within the primary pack.A nonconformity(nc) was opened for this issue for foreign matter on the dressing.An investigation was raised and identified that the root cause was personnel, as the foreign matter was a human hair.A corrective/preventative action (capa) was raised to cover corrective and preventative actions for retraining of personnel in manufacturing for good manufacturing practice (gmp), awareness training for bulk packing and microbiology training for manufacturing shifts.This issue will be monitored through the post market product monitoring review process, standard operating procedure (sop).Fda registration number: reporting site: 1049092.Manufacturing site: 1000317571.
 
Event Description
To date no additional patient or event details have been received.
 
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Brand Name
AQUACEL FOAM
Type of Device
DRESSING,WOUND,HYDROPHILIC
Manufacturer (Section D)
CONVATEC LTD
first avenue
deeside industrial park
deeside, flintshire CH5 2 NU
UK  CH5 2NU
Manufacturer (Section G)
CONVATEC LTD
first avenue
deeside industrial park
deeside, flintshire CH5 2 NU
UK   CH5 2NU
Manufacturer Contact
pamela meadows
7815 national service road
suite 600
greensboro, NC 
3365424679
MDR Report Key15585667
MDR Text Key302937991
Report Number1000317571-2022-00328
Device Sequence Number1
Product Code NAC
UDI-Device Identifier00768455123841
UDI-Public00768455123841
Combination Product (y/n)N
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Distributor
Reporter Occupation Non-Healthcare Professional
Type of Report Initial,Followup
Report Date 09/19/2022
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
Device Operator Other
Device Model Number420635
Device Catalogue Number420635
Device Lot Number1C00248
Was Device Available for Evaluation? No
Was the Report Sent to FDA? Yes
Initial Date Manufacturer Received 09/19/2022
Initial Date FDA Received10/12/2022
Supplement Dates Manufacturer Received01/05/2023
Supplement Dates FDA Received01/23/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured03/03/2021
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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