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Product complaint # (b)(4).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 inc, or its employees that the report constitutes an admission that the product, ethicon inc 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.A manufacturing record evaluation was performed for the finished device lot, and no non-conformances were identified.Attempts have been made to retrieve the device.To date the device has not been returned.If the device or further details are received at a later date a supplemental medwatch will be sent.Additional information was requested, and the following was obtained: please translate: producto de dermabond, cirujano manifiesta el miemo dia de haber puesto el producto se despegó.Translation received: the surgeon reports that, on the same day the product was applied, it became detached.Attempts have been made to retrieve the device.To date the device has not been returned.If the device or further details are received at a later date a supplemental medwatch will be sent.***please clarify*** is this complaint about ethibond suture with product code ec11, lot 108hrb? is this complaint against dermabond? if yes, please describe the issue.Is this complaint for both dermabond and ethibond suture? ***please explain in detail what happened including a timeline of events*** did the needle pull off of the suture during the initial procedure? did the suture break intraoperatively? did the suture break post-operatively? did the patient experience a post-op wound dehiscence? did the patient experience any adverse symptoms? if yes, explain.Did the patient require any medical or surgical intervention due to this event? if yes, please explain.If this complaint is against dermabond, please explain what ¿it became detached¿ means: did the dermabond peel off? if yes, did the dermabond need to be reapplied? please provide the patient's demographic information including age, gender, weight, bmi at the time of index procedure.Name of index surgical procedure? the diagnosis and indication for the index surgical procedure? were any concomitant procedures performed? what was the initial approach for the index surgical procedure? (open, laparoscopic or other)? on what tissue was the suture used? what was the tissue condition (normal, thin, calcified, fragile, diseased)? for the original intended closure, how were all layers closed? how was the suture placed (interrupted or continuous)? how was the suture originally tied (multiple knots, square knot, etc.)? did the patient experience a post-op wound dehiscence? if yes, what tissue dehisced? onset date/time of dehiscence? (# post op days) how was the dehiscence managed? please describe any medical or surgical intervention required including date and findings.Please describe the appearance of the suture during the second procedure, if applicable.Did the suture break? if so, where was the break noted (termination, middle, end)? did the suture pull out of the tissue? did the knots untie? were there any precipitating patient stress factors that led to the sutures untying, breakage or pulling out of the tissue? are photos available? did the operating surgeon observe any suture deficiency or anomaly before, during, after the suture placement or during any re-operation? other relevant patient history/concomitant medications? what is the physician¿s opinion as to the etiology of or contributing factors to this event? what is the patient's current status? surgeon¿s name? will product be returned? if so, please provide the return date and tracking information.
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Product complaint # (b)(4).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 inc, or its employees that the report constitutes an admission that the product, ethicon inc 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.Additional information: b1, product problem.
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