FDA Adverse Event Injury Summary report: N

PHASIX MESH

MDR report key: 13006110 · Received December 14, 2021

Report

Report Number
1213643-2021-20462
Event Type
Injury
Date Received
December 14, 2021
Date of Event
November 30, 2021
Report Date
April 6, 2022
Manufacturer
DAVOL INC., SUB. C.R. BARD, INC. -1213643
Product Code
OOD
UDI-DI
00801741107610
PMA / PMN Number
K161424
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AS REPORTED, 11 DAYS POST-IMPLANT OF THE PHASIX MESH, THE PATIENT EXPERIENCED A POSTOPERATIVE HEMATOMA THAT REQUIRED EVACUATION AND STAPLE REMOVAL. THE CLINICIAN HAS ASSESSED THE PATIENT¿S POSTOPERATIVE COURSE AS BEING ¿POSSIBLY¿ RELATED TO THE STUDY DEVICE AND DEFINITELY RELATED TO THE INDEX PROCEDURE; HOWEVER, BASED ON THE INFORMATION PROVIDED, NO CONCLUSION CAN BE MADE. HEMATOMA IS A KNOWN INHERENT RISK OF SURGERY AND IS LISTED IN THE ADVERSE REACTIONS SECTION OF THE INSTRUCTIONS-FOR-USE (IFU) SUPPLIED WITH THE DEVICE AS A POSSIBLE COMPLICATION. REVIEW OF MANUFACTURING RECORDS CONFIRMS PRODUCT WAS MANUFACTURED TO SPECIFICATION, WITH NO INDICATION OF A MANUFACTURING RELATED CAUSE FOR THE EVENT REPORTED. ADDENDUM: THIS IS AN ADDENDUM TO THE PREVIOUSLY SUBMITTED MDR TO REPORT ADDITIONAL INFORMATION PROVIDED. AS REPORTED, SEVEN MONTHS POST-IMPLANT, THE PATIENT WITH A MEDICAL HISTORY OF SMALL BOWEL OBSTRUCTION (SBO), DEVELOPED A SBO AND UNDERWENT EXPLORATORY SURGERY, DURING WHICH THE MESH WAS EXPLANTED. THE CLINICIAN HAS ASSESSED THE ADVERSE EVENT TO BE NOT RELATED THE STUDY DEVICE AND POSSIBLY RELATED TO THE INDEX PROCEDURE, HOWEVER, BASED ON THE INFORMATION PROVIDED, NO CONCLUSION CAN BE MADE. NOTE: SECTION A THROUGH F - THE INFORMATION PROVIDED BY BD 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 BD. H3 OTHER TEXT : NOT RETURNED - MESH EXPLANTED.

Additional Manufacturer Narrative · 0

AS REPORTED, 11 DAYS POST-IMPLANT OF THE PHASIX MESH, THE PATIENT EXPERIENCED A POSTOPERATIVE HEMATOMA THAT REQUIRED EVACUATION AND STAPLE REMOVAL. THE CLINICIAN HAS ASSESSED THE PATIENT¿S POSTOPERATIVE COURSE AS BEING ¿POSSIBLY¿ RELATED TO THE STUDY DEVICE AND DEFINITELY RELATED TO THE INDEX PROCEDURE; HOWEVER, BASED ON THE INFORMATION PROVIDED, NO CONCLUSION CAN BE MADE. HEMATOMA IS A KNOWN INHERENT RISK OF SURGERY AND IS LISTED IN THE ADVERSE REACTIONS SECTION OF THE INSTRUCTIONS-FOR-USE (IFU) SUPPLIED WITH THE DEVICE AS A POSSIBLE COMPLICATION. REVIEW OF MANUFACTURING RECORDS CONFIRMS PRODUCT WAS MANUFACTURED TO SPECIFICATION, WITH NO INDICATION OF A MANUFACTURING RELATED CAUSE FOR THE EVENT REPORTED. SHOULD ADDITIONAL INFORMATION BE PROVIDED, A SUPPLEMENTAL MDR WILL BE SUBMITTED.

Description of Event or Problem · 0

AS REPORTED PER PREVENT CLINICAL TRIAL (B)(6): ON (B)(6) 2021, DURING AN OPEN RELAPAROTOMY OSTOMY PROCEDURE, THE STUDY PATIENT WAS IMPLANTED WITH A BARD/DAVOL PHASIX MESH WHICH WAS TRIMMED AND PLACED IN AN ONLAY FASHION. SKIN INCISIONS ( SIZE-18CM) WERE MADE STRAIGHT NEAR THE EPIGASTRIC AND UMBILICAL REGION. MIDLINE FASCIA CLOSURE WAS ACHIEVED USING A NON-BARD/DAVOL SINGLE SUTURE, IN A RUNNING STITCH TECHNIQUE. ALSO, AN ABSORBABLE 1-PDS SUTURE WAS USED FOR SECURING THE MESH AND FINAL SKIN CLOSURE WAS ACHIEVED WITH STAPLES. AS REPORTED, THERE WAS NO ACTIVE SKIN PATHOLOGY AT THE TIME OF IMPLANT AND ANTIBIOTICS WERE ADMINISTERED PERI-OPERATIVELY; THE PATIENT WAS DISCHARGED FROM THE HOSPITAL ON (B)(6) 2021. AS REPORTED, ON (B)(6) 2021, THE STUDY PATIENT WAS DIAGNOSED WITH A HEMATOMA THAT REQUIRED STAPLE REMOVAL. THE SUBJECT PATIENT WAS ADMITTED TO THE HOSPITAL AND WAS ADMINISTERED VANCOMYCIN (750MG) EVERY 12 HRS. ON ADMISSION AND SWITCHED TO PO AUGMENTIN ON ADMIT DAY. AS REPORTED, THE HEMATOMA WAS EVACUATED BEDSIDE IN THE EMERGENCY DEPARTMENT. CULTURE WAS NOT TAKEN. THE STAPLES WERE REMOVED AT THE LOWER INCISION AND THE STUDY PATIENT WAS DISCHARGED HOME WITH THREE TIMES WEEKLY DRESSING CHANGES WITH AQUACEL AG PACKING WITH HOME HEALTH. AS REPORTED, THE PATIENT IS TOLERATING THE PACKING CHANGES AND REPORTS SOME DRAINAGE FROM THE AREA, BUT IS CONTROLLED WITH DRESSING. THE STUDY CLINICIAN HAS ASSESSED THE REPORTED ADVERSE EVENT (AE) AS POSSIBLY RELATED TO THE STUDY DEVICE AND DEFINITELY RELATED TO THE INDEX PROCEDURE. THE ADVERSE EVENT HAS BEEN ASSESSED TO BE OF MILD SEVERITY. ADDENDUM PER EMAIL NOTIFICATION FROM CLINICAL TRIAL SITE: ON (B)(6) 2022, THE PATIENT WAS DIAGNOSED WITH SMALL BOWEL OBSTRUCTION (SBO) AND UNDERWENT AN EXPLORATORY LAPAROTOMY WITH COMPLETE REMOVAL OF THE PHASIX MESH. AS REPORTED, THIS ADVERSE EVENT HAS BEEN ASSESSED PER THE STUDY CLINICIAN AS MODERATE IN SEVERITY AND NOT RECOVERED/NOT RESOLVED. THE STUDY CLINICIAN HAS ASSESSED THE ADVERSE EVENT TO BE NOT RELATED THE STUDY DEVICE AND POSSIBLY RELATED TO THE INDEX PROCEDURE. THE REPORTED EVENT HAS BEEN ASSESSED TO MEET THE DEFINITION OF A SERIOUS ADVERSE EVENT (SAE). THE REPORTED EVENT DOES NOT MEET THE DEFINITION OF AN UNIDENTIFIED ADVERSE DEVICE EVENT (UADE).

Description of Event or Problem · 0

AS REPORTED PER PREVENT CLINICAL TRIAL (B)(4): ON (B)(6) 2021, DURING AN OPEN RELAPAROTOMY OSTOMY PROCEDURE, THE STUDY PATIENT WAS IMPLANTED WITH A BARD/DAVOL PHASIX MESH WHICH WAS TRIMMED AND PLACED IN AN ONLAY FASHION. SKIN INCISIONS ( SIZE-18CM) WERE MADE STRAIGHT NEAR THE EPIGASTRIC AND UMBILICAL REGION. MIDLINE FASCIA CLOSURE WAS ACHIEVED USING A NON-BARD/DAVOL SINGLE SUTURE, IN A RUNNING STITCH TECHNIQUE. ALSO, AN ABSORBABLE 1-PDS SUTURE WAS USED FOR SECURING THE MESH AND FINAL SKIN CLOSURE WAS ACHIEVED WITH STAPLES. AS REPORTED, THERE WAS NO ACTIVE SKIN PATHOLOGY AT THE TIME OF IMPLANT AND ANTIBIOTICS WERE ADMINISTERED PERI-OPERATIVELY; THE PATIENT WAS DISCHARGED FROM THE HOSPITAL ON (B)(6) 2021. AS REPORTED, ON (B)(6) 2021, THE STUDY PATIENT WAS DIAGNOSED WITH A HEMATOMA THAT REQUIRED STAPLE REMOVAL. THE SUBJECT PATIENT WAS ADMITTED TO THE HOSPITAL AND WAS ADMINISTERED VANCOMYCIN (750MG) EVERY 12 HRS. ON ADMISSION AND SWITCHED TO PO AUGMENTIN ON ADMIT DAY. AS REPORTED, THE HEMATOMA WAS EVACUATED BEDSIDE IN THE EMERGENCY DEPARTMENT. CULTURE WAS NOT TAKEN. THE STAPLES WERE REMOVED AT THE LOWER INCISION AND THE STUDY PATIENT WAS DISCHARGED HOME WITH THREE TIMES WEEKLY DRESSING CHANGES WITH AQUACEL AG PACKING WITH HOME HEALTH. AS REPORTED, THE PATIENT IS TOLERATING THE PACKING CHANGES AND REPORTS SOME DRAINAGE FROM THE AREA, BUT IS CONTROLLED WITH DRESSING. THE STUDY CLINICIAN HAS ASSESSED THE REPORTED ADVERSE EVENT (AE) AS POSSIBLY RELATED TO THE STUDY DEVICE AND DEFINITELY RELATED TO THE INDEX PROCEDURE. THE ADVERSE EVENT HAS BEEN ASSESSED TO BE OF MILD SEVERITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1898074 PHASIX MESH SURGICAL MESH OOD DAVOL INC., SUB. C.R. BARD, INC. -1213643 NA HUDY1470 00801741107610

Patients

Seq Age Sex Outcome Treatment
1 58 YR Female Required Intervention| H