inforMED
InjuryEZR

STOMAHESIVE PASTE

Received Aug 1, 2014 · Event occurred Sep 7, 2011

Report 2243969-2014-10407 · MDR key 4039807

Device

Generic name

Protector, Ostomy

Manufacturer

Convatec Inc.

Model number

183910

Product problems

  • Human-Device Interface Problem

Patient

UNK

  • Ulceration

Narrative

Additional Manufacturer Narrative

CONVATEC IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO THE FDA 483 ISSUED APRIL 16, 2014. DEVICE(S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILLING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. TWELVE MONTHS OF COMPLAINT HISTORY DATA WAS REVIEWED FOR THIS PRODUCT ICC. BASED ON THE REVIEW, (B)(4) CASES WERE REGISTERED FOR ALLERGIC REACTION WITH ICC NUMBER (B)(4) WITHIN THE PREVIOUS 12 MONTHS. CONVATEC WILL CONTINUE TO MONITOR THESE COMPLAINTS.

Description of Event or Problem

REPORT RECEIVED INDICATED THAT THE PATIENT WAS PRESCRIBED AN OSTOMY PASTE TO USE ON A "DIABETIC-TYPE" ULCERATION IN ORDER TO ENSURE A PROPER SEAL WITH A WOUND VACUUM. AFTER A FEW HOURS, THE PATIENT REPORTED THEY BEGAN TO FEEL "STRANGE, UNEASY, ANXIOUS AND PARANOID AND STARTED TO HAVE MILD HALLUCINATIONS AND/OR DELUSIONS. THE PATIENT REPORTEDLY RECEIVED MEDICAL INTERVENTION; HOWEVER, NO DETAILS REGARDING THE NATURE OF THE TREATMENT RENDERED WERE PROVIDED. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.