PRIMATRIX MESHED 4 X 4CM 607-005-440

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2017-04-19 for PRIMATRIX MESHED 4 X 4CM 607-005-440 manufactured by Tei Biosciences Inc.

Event Text Entries

[73101685] The device involved in the reported incident is not available for evaluation. An investigation has been initiated based on the reported information.
Patient Sequence No: 1, Text Type: N, H10


[73101686] It was reported by the patient that she has a bump on her right ankle after a muscle hernia repair with primatrix. Medical intervention was required to remove the primatrix on (b)(6) 2017. Additional information received on april 16, 2017 from the patient: "for the right leg i still have it in my left leg without problem. My problem is mainly scar tissue build up which may or may not have been caused by the product. I am starting to think it's not. But my concern is that i have 4 more muscle hernias from rollerblading and i switched doctors but if they choose to repair id much rather have the primatrix biodegradable versus a plastic mesh because it's working very well in the left leg. Only the right leg had the problem. I was actually going to ask them to try it again on the other hernias that are causing me pain. Like i said i had primatrix in both ankles and it was only removed in one but the doctor didn't see that it was causing a problem rather just a bunch of scar tissue building up around the surgery site where the muscle was removed and the primatrix placed. " additional information has been requested.
Patient Sequence No: 1, Text Type: D, B5


[74800072] Additional information received from the patient on (b)(6) 2017: - age: (b)(6) - reason for implantation: muscle hernia repair. - date of initial surgery: (b)(6) 2017. - date noticed bump: (b)(6) 2017. - description of bump: red, shiny, size of a fingernail. - is it painful? - very. - discharge? - no. - did you went to the doctor? I did go to the doctor. - treatment plan prescribed- removal of device ((b)(6) 2017). - additional studies performed- none. - additional procedure scheduled- not at the moment but possible in few months - how are you doing now? I am with the same problem around the area where the device was as scar tissue filled the areas.
Patient Sequence No: 1, Text Type: N, H10


[75839027] Integra has completed their internal investigation on may 10, 2017. Results: device has not been returned for evaluation, therefore failure analysis cannot be performed. Dhr review; all product specifications were met. There are no non-conformances or capas associated with this product lot. Complaints history; a trackwise search was conducted for complaints specifying "bump" for this trend analysis; this is the only complaint of a bump related to primatrix within the past year. Complaint rate: one complaint of (b)(4) units sold within the past year; (b)(4). Conclusion: device has not been returned for evaluation, therefore root cause analysis cannot be performed.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3004170064-2017-00002
MDR Report Key6502949
Report SourceCONSUMER
Date Received2017-04-19
Date of Report2017-04-03
Date of Event2017-03-22
Date Mfgr Received2017-05-10
Date Added to Maude2017-04-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactUSER SONIA IRIZARRY
Manufacturer Street311 ENTERPRISE DRIVE
Manufacturer CityPLAINSBORO NJ 08536
Manufacturer CountryUS
Manufacturer Postal08536
Manufacturer Phone6099362393
Manufacturer G1TEI BIOSCIENCES INC
Manufacturer Street7 ELKINS STREET
Manufacturer CityBOSTON MA 02127
Manufacturer CountryUS
Manufacturer Postal Code02127
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePRIMATRIX MESHED 4 X 4CM
Generic NamePRIMATRIX
Product CodeKGN
Date Received2017-04-19
Catalog Number607-005-440
Lot Number1509057
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTEI BIOSCIENCES INC
Manufacturer Address7 ELKINS STREET 7 ELKINS STREET BOSTON MA 02127 US 02127


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-04-19

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