PHASIX MESH 1190400

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2018-04-19 for PHASIX MESH 1190400 manufactured by Davol Inc., Sub. C.r. Bard, Inc..

Event Text Entries

[105963100] There is no connection that can be made at this time between the reported post-operative complications and the bard/davol phasix (device 3) used to treat the patient. The patient's attorney alleges hernia recurrence however, hernia is a known inherent risk of surgery and is listed in the instructions-for-use a possible complication. No sample was returned for evaluation and medical records are not available. A lot number was not provided, therefore a review of manufacturing records is not possible at this time. Based on the limited information provided, no conclusions can be made between the reported post-operative complications and the bard davol phasix (device 3). Should additional information be provided, a supplemental emdr will be submitted. This emdr represents the bard/davol phasix mesh (device 3) implanted on (b)(6) 2016; an additional emdr will be submitted to represent the bard/davol ventralight st with echo ps (device 1) implanted on (b)(6) 2014 and the bard davol ventralight st with echo ps (device 2) implanted on (b)(6) 2015. Note: 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. Not returned.
Patient Sequence No: 1, Text Type: N, H10


[105963101] The following was alleged by the patient's attorney: on (b)(6) 2014 - the patient underwent a symptomatic incisional hernia repair procedure a ventralight st with echo ps (device 1) was implanted in the patient? S peritoneal cavity to reinforce tissue affected by the hernia. On (b)(6) 2015 - the patient underwent a subsequent surgery to repair a recurrent right epigastric incisional hernia. It was during this surgery that another ventralight st with echo ps (device 2) was implanted into the patient to correct what was seen to be a complex hernia where the previous mesh was? Wrinkled up to the right side of the abdominal wall.? On (b)(6) 2016 - the patient underwent a third surgery to repair a component separation ventral incisional hernia. It was during this third surgery that a phasix mesh (device 3) was implanted into the patient. During this procedure, both ventralight st mesh? S that were implanted in patient "in 2014 and 2015, respectively, were repaired and removed from patient? S abdomen. " doctor "chose to excise one mesh product in its entirety, while only removing half of the other mesh. " as reported, "to this day, one half of the ventralight st with echo ps remains implanted in the patient as well as the most recently placed phasix mesh (device 3)" the patient's attorney alleges that the "patient continues to experience stomach pain and recurring hernias since the multiple procedures and hernia mesh implants surgeries and removals. Patient has difficulty digesting nutrients she consumes without pain and bloating. Patient is not able to perform day to day tasks such as lifting minorly heavy objects or raking leaves. These injuries were not present before the implantation of the mesh products. " further alleged by the patient's attorney: "as a direct and proximate result of the implanted mesh products into her body, patient suffered, is suffering and/or will continue to suffer the abovementioned injuries. " and that the "patient has suffered severe and possibly permanent injuries. "
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1213643-2018-01148
MDR Report Key7444512
Report SourceCONSUMER,OTHER
Date Received2018-04-19
Date of Report2018-11-08
Date Mfgr Received2018-10-17
Date Added to Maude2018-04-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationATTORNEY
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactSTEVEN FIGUEROA
Manufacturer Street100 CROSSINGS BLVD.
Manufacturer CityWARWICK RI 02886
Manufacturer CountryUS
Manufacturer Postal02886
Manufacturer Phone4018258605
Manufacturer G1BARD SHANNON LIMITED -3005636544
Manufacturer StreetSAN GERONIMO INDUSTRIAL PARK LOT #1, ROAD #3, KM 79.7
Manufacturer CityHUMACAO PR 00791
Manufacturer CountryUS
Manufacturer Postal Code00791
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePHASIX MESH
Generic NameSURGICAL MESH
Product CodeOOD
Date Received2018-04-19
Model NumberNA
Catalog Number1190400
Lot NumberNI
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDAVOL INC., SUB. C.R. BARD, INC.
Manufacturer Address100 CROSSINGS BLVD. WARWICK RI 02886 US 02886


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention; 2. Deathisabilit 2018-04-19

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