inforMED
MalfunctionFZP

GEL MARK ULTRA BREAST TISSUE MARKER

Received Apr 17, 2018 · Event occurred Oct 1, 2014

Report 2020394-2018-00400 · MDR key 7438655

Device

Generic name

Implantable Clip

Model number

GMUEC10GSS

Catalog number

GMUEC10GSS

Lot number

UNK

Product problems

  • Patient-Device Incompatibility
  • Patient-Device Incompatibility

Patient

Not reported

  • Urticaria
  • Urticaria

Narrative

Additional Manufacturer Narrative

AS THE LOT NUMBER FOR THE DEVICE WAS NOT PROVIDED, A MANUFACTURING REVIEW COULD NOT BE PERFORMED. THE SAMPLE WAS NOT RETURNED TO THE MANUFACTURER FOR INSPECTION/EVALUATION. THEREFORE, THE INVESTIGATION OF THE REPORTED EVENT IS INCONCLUSIVE. BASED UPON THE AVAILABLE INFORMATION, THE DEFINITIVE ROOT CAUSE FOR THIS EVENT IS UNKNOWN. THE INSTRUCTIONS FOR USE (IFU) IS ADEQUATE AND PROVIDES GENERAL INSTRUCTIONS FOR USE, AS WELL AS WARNINGS, PRECAUTIONS AND POTENTIAL COMPLICATIONS ASSOCIATED WITH THE DEVICE. UPON RECEIPT OF NEW OR ADDITIONAL INFORMATION, A FOLLOW-UP REPORT WILL BE SUBMITTED AS APPLICABLE. THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD.

Description of Event or Problem

IT WAS REPORTED THAT POST PLACEMENT OF A BREAST TISSUE MARKER, THE PATIENT ALLEGEDLY HAD EPISODES OF IDIOPATHIC URTICARIA. THERE WAS NO REPORTED PATIENT INJURY.