inforMED
MalfunctionGAM

POLYSORB

Received Nov 6, 2024 · Event occurred Oct 25, 2024

Report 1219930-2024-05223 · MDR key 20623143

Device

Generic name

Suture, Absorbable, Synthetic, Polyglycolic Ac

Model number

GL-124

Catalog number

GL-124

Lot number

A4E1782Y

Product problems

  • Detachment of Device or Device Component
  • Detachment of Device or Device Component

Patient

44 YR · Female

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

ACCORDING TO THE REPORTER, DURING AN EVENTRATION INGUINAL HERNIA PROCEDURE, THREE NEEDLES DETACHED. THE THREAD SEPARATED FROM THE NEEDLE BOTH WHEN REMOVING IT FROM THE PACKAGE AND WHEN SUTURING. A NEW SUTURE WAS USED TO RESOLVE THE ISSUE. THERE WAS NO PATIENT INJURY.

Additional Manufacturer Narrative

D10 CONCOMITANT PRODUCT: GL-124, GL-124 POLYSORB* 0 VIO 75CM V20 X36 (LOT# A4E1782Y), GL-124, GL-124 POLYSORB* 0 VIO 75CM V20 X36 (LOT# A4E1782Y) MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.