FDA Adverse Event Injury Summary report: N

BARRICAID ACD

MDR report key: 15775565 · Received November 10, 2022

Report

Report Number
3006232063-2022-00037
Event Type
Injury
Date Received
November 10, 2022
Date of Event
January 22, 2022
Report Date
December 22, 2022
Manufacturer
INTRINSIC THERAPEUTICS, INC
Product Code
QES
UDI-DI
M906BARA810MM0
PMA / PMN Number
P160050
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

IMPLANT WAS OBSERVED TO BE IN ORIGINAL POSITION DURING SURGERY. SCAR TISSUE WAS IDENTIFIED BY THE SURGEON WHICH LIKELY CONTRIBUTED TO THE LEG PAIN THE PATIENT WAS EXPERIENCING. THE MESH WAS REMOVED DURING SURGERY BUT THE TITANIUM ANCHOR REMAINED IMPLANTED. A TLIF WAS PERFORMED BY THE SURGEON IMPLANT MESH WAS RETRIEVED AND SENT TO A 3RD PARTY LABORATORY FOR EVALUATION PER PAS002 "EXPONENT PRO.214, INTRINSIC BARRICAID RETRIEVAL PROTOCOL" RESULTS OF PAS ARE SUBMITTED ANNUALLY.

Additional Manufacturer Narrative · 0

INTRINSIC BECAME AWARE OF A PRIOR SURGERY WHILE INVESTIGATING (B)(4) AND ON 06-DEC-2022 THE SURGEON PROVIDED US THE DETAILS. THE DEVICE WAS NOT BELIEVED TO BE INVOLVED SINCE THE SURGEON LEFT IT IMPLANTED. THIS ALL OCCURRED BEFORE WE BECAME AWARE OF (B)(4) INITIAL CASE DETAILS.

Description of Event or Problem · 0

PATIENT UNDERWENT A REVISION SURGERY THAT CONSISTED OF: MESH REMOVAL WITH TLIF. INDICATIONS: LEG PAIN. SCAR TISSUE WHICH WAS NOT DUE TO IMPLANT WAS IDENTIFIED UPON DECOMPRESSION, NO HNP, IMPLANT IN ORIGINAL POSITION. BMI AT TIME OF RE-OP WAS 45.27.

Description of Event or Problem · 0

PATIENT HAD A HERNIATION AFTER INITIAL BARRICAID IMPLANTATION. THERE WAS A REVISION SURGERY ON (B)(6) 2022 TO RESECT HNP AND LEFT BARRICAID DEVICE IN PLACE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1911392 BARRICAID ACD BARRICAID QES INTRINSIC THERAPEUTICS, INC BAR-A8-10MM 07212002 M906BARA810MM0

Patients

Seq Age Sex Outcome Treatment
1 23 YR Male Required Intervention