PHASIX MESH 1190300

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,other,stu report with the FDA on 2018-11-05 for PHASIX MESH 1190300 manufactured by Davol Inc., Sub. C.r. Bard, Inc..

Event Text Entries

[126069250] No conclusion can be made. As reported, the reason for the hernia recurrence was "poor healing/poor adhesion development. " based on the information provided at this time,we are unable to determine to what degree, if any, the mesh implant used to treat the patient may have caused or contributed to the patient's condition and hernia recurrence. Recurrence is a known inherent risk of hernia repair surgery with or without the use of mesh. Recurrence is listed in the adverse reaction section of the instructions-for-use as a possible complication. A review of the manufacturing records was performed and found that the lot was manufactured to specification. Should additional information be provided, a supplemental emdr will be submitted. 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


[126069251] It was reported that a patient who is part of a clinical study ((b)(46)) experienced a hernia recurrence on (b)(6) 2015 - the subject patient underwent the repair of a midline incisional hernia using the phasix mesh. Absorbable monofilament sutures were used to fixate the mesh and the fascia/skin were fully closed. On (b)(6) 2017 - the subject patient was diagnosed with a recurrent midline incisional hernia. This adverse event was assessed at this time, as moderate in severity, possibly related to the study device and possibly related to the index procedure. On (b)(6) 2018 - the subject patient underwent repair of the recurrent hernia (primarily with no mesh), with explant of the phasix mesh. The fascia/skin were fully closed. As reported, the reason for the hernia recurrence was "poor healing/poor adhesion development. "
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1213643-2018-03835
MDR Report Key8037027
Report SourceHEALTH PROFESSIONAL,OTHER,STU
Date Received2018-11-05
Date of Report2018-11-05
Date of Event2018-10-09
Date Mfgr Received2018-10-11
Device Manufacturer Date2013-01-15
Date Added to Maude2018-11-05
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 ContactLAURA SUNDBERG
Manufacturer Street100 CROSSINGS BLVD.
Manufacturer CityWARWICK RI 02886
Manufacturer CountryUS
Manufacturer Postal02886
Manufacturer Phone4018258462
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 Received2018-11-05
Model NumberNA
Catalog Number1190300
Lot NumberHUXKTP21
Device Expiration Date2015-11-28
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
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 2018-11-05

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