MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2017-08-17 for FENIX CONTINENCE RESTORATION SYSTEM FXS16 NA manufactured by Torax Medical, Inc..
[82977162]
Following a surgical procedure for reinforcement of the anal sphincter due to fecal incontinence, a patient was found to have fenix beads eroded through the anal canal leading to fenix device explant. The fenix device was used as part of the surgical procedure. -uneventful surgical procedure and device implant on (b)(6)2017; 3-4 vessels were stitched during the implant procedure to decrease bleeding. -the patient presented with discharge and tenderness; during a digital rectal exam the device was found to have eroded into the anterior rectum on (b)(6)2017. Symptoms began (b)(6)2017. -uneventful device explant (b)(6)2017 due to 2 fenix device beads found eroded through the anal canal; an infection was present at the exposure site. The fenix device was removed transanally. The device was intact at the time of explant.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 3008766073-2017-00095 |
MDR Report Key | 6802365 |
Report Source | COMPANY REPRESENTATIVE,HEALTH |
Date Received | 2017-08-17 |
Date of Report | 2017-08-31 |
Date of Event | 2017-07-20 |
Date Mfgr Received | 2017-08-31 |
Device Manufacturer Date | 2016-03-16 |
Date Added to Maude | 2017-08-17 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MS. JESSICA AHLBORN |
Manufacturer Street | 4188 LEXINGTON AVENUE NORTH |
Manufacturer City | SHOREVIEW MN 55126 |
Manufacturer Country | US |
Manufacturer Postal | 55126 |
Manufacturer Phone | 6513618900 |
Manufacturer G1 | TORAX MEDICAL, INC. |
Manufacturer Street | 4188 LEXINGTON AVENUE NORTH |
Manufacturer City | SHOREVIEW MN 55126 |
Manufacturer Country | US |
Manufacturer Postal Code | 55126 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | FENIX CONTINENCE RESTORATION SYSTEM |
Generic Name | IMPLANTED FECAL INCONTINENCE DEVICE |
Product Code | PMH |
Date Received | 2017-08-17 |
Returned To Mfg | 2017-08-28 |
Model Number | FXS16 |
Catalog Number | NA |
Lot Number | 10522 |
Operator | PHYSICIAN |
Device Availability | R |
Device Age | DA |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | TORAX MEDICAL, INC. |
Manufacturer Address | 4188 LEXINGTON AVENUE N SHOREVIEW MN 55126 US 55126 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Hospitalization; 2. Deathisabilit | 2017-08-17 |