FDA Adverse Event Injury Summary report: N

STRATTICE RECONSTRUCTIVE TISSUE MATRIX, 20 X 30, FIRM

MDR report key: 16039744 · Received December 22, 2022

Report

Report Number
1000306051-2022-00210
Event Type
Injury
Date Received
December 22, 2022
Date of Event
September 19, 2014
Report Date
January 6, 2023
Product Code
FTM
PMA / PMN Number
K070560
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THIS LEGAL EVENT IS BEING REPORTED AS SERIOUS INJURY DUE TO THE REPORTED RECURRENCE WITH SURGICAL INTERVENTION. THE INTERNAL INVESTIGATION IS PENDING AND WILL BE REPORTED IN A FOLLOW UP REPORT ALONG WITH THE INVESTIGATION CONCLUSION.

Additional Manufacturer Narrative · 0

THIS FOLLOW UP IS TO REPORT THE RESULTS FROM THE INTERNAL INVESTIGATION AND CONCLUSION. INTERNAL INVESTIGATION INTO STRATTICE LOT SP100043 INCLUDED A REVIEW OF THE REPORTED INFORMATION, REVIEW OF THE DEVICE HISTORY RECORDS, AND A REVIEW OF THE COMPLAINT HISTORY RECORDS. THE INVESTIGATION RESULTED IN NO REMARKABLE FINDINGS, INCLUDING NO OTHER COMPLAINTS REPORTED AGAINST THE LOT AND NO DEVIATIONS OR RELATED NON-CONFORMANCES REVEALED DURING PROCESSING. THE LOT WAS TERMINALLY STERILIZED WITHIN THE PROCESS PARAMETERS AND MET ALL QC RELEASE CRITERIA. AS OF 01/05/2023, OF THE (B)(4) DEVICES RELEASED TO FINISHED GOODS FOR LOT SP100043, (B)(4) HAVE BEEN DISTRIBUTED WITH (B)(4) REPORTED AS IMPLANTED. BASED ON OUR INTERNAL INVESTIGATION WITH NO REMARKABLE FINDINGS, AND WITHOUT RELEVANT PATIENT FACTORS, A RELATIONSHIP BETWEEN THE STRATTICE AND THIS EVENT COULD NOT BE DETERMINED. DUE TO THE LEGAL PROCESS, IF ADDITIONAL INFORMATION IS MADE AVAILABLE DURING LEGAL PROCEEDINGS, A SUPPLEMENTAL REPORT WILL BE SUBMITTED AS REPORTED IN THE INITIAL: THIS LEGAL EVENT IS BEING REPORTED AS SERIOUS INJURY DUE TO THE REPORTED RECURRENCE WITH SURGICAL INTERVENTION. THE INTERNAL INVESTIGATION IS PENDING AND WILL BE REPORTED IN A FOLLOW UP REPORT ALONG WITH THE INVESTIGATION CONCLUSION.

Description of Event or Problem · 0

IT WAS REPORTED THROUGH A LEGAL EVENT THAT A 59 YEAR OLD FEMALE PATIENT HAD HERNIA REPAIR SURGERY ON OR ABOUT (B)(6) 2013. DURING THE HERNIA REPAIR SURGERY, THE SURGEON IMPLANTED A STRATTICE MESH; LOT # SP100043-148 REF # (B)(4). AFTER SURGERY, THE PATIENT RETURNED TO THE HOSPITAL ON OR ABOUT (B)(6) 2014, FOR REPAIR OF A RECURRENT VENTRAL HERNIA. ON OR ABOUT (B)(6) 2020, THE PATIENT HAD ANOTHER STRATTICE MESH IMPLANTED FOR VENTRAL HERNIA REPAIR. THE LOT# IS SP200144-137 AND THE REF# IS (B)(4). IN (B)(6) 2022, THE PATIENT PRESENTED TO THE HOSPITAL FOR A REVISION SURGERY. NO OTHER INFORMATION WAS PROVIDED. THIS RECORD IS ASSOCIATED WITH SP100043-148 REF # (B)(4); IMPLANTED (B)(6) 2013.

Description of Event or Problem · 0

THIS IS FOLLOW UP #1 TO REPORT THE RESULTS FROM THE INTERNAL INVESTIGATION AND THE CONCLUSION. THE AWARE DATE OF JANUARY 5TH, 2023 IS BASED ON WHEN THE BATCH RECORD REVIEW WAS COMPLETED. AS REPORTED IN THE INITIAL: IT WAS REPORTED THROUGH A LEGAL EVENT THAT A 59 YEAR OLD FEMALE PATIENT HAD HERNIA REPAIR SURGERY ON OR ABOUT (B)(6) 2013. DURING THE HERNIA REPAIR SURGERY, THE SURGEON IMPLANTED A STRATTICE MESH; LOT # SP100043 REF # 2030002. AFTER SURGERY, THE PATIENT RETURNED TO THE HOSPITAL ON OR ABOUT (B)(6) 2014, FOR REPAIR OF A RECURRENT VENTRAL HERNIA. ON OR ABOUT (B)(6) 2020, THE PATIENT HAD ANOTHER STRATTICE MESH IMPLANTED FOR VENTRAL HERNIA REPAIR. THE LOT# IS SP200144 AND THE REF# IS 20300002. IN (B)(6) 2022, THE PATIENT PRESENTED TO THE HOSPITAL FOR A REVISION SURGERY. NO OTHER INFORMATION WAS PROVIDED. THIS RECORD IS ASSOCIATED WITH (B)(6) REF # 2030002; IMPLANTED (B)(6) 2013.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1739439 STRATTICE RECONSTRUCTIVE TISSUE MATRIX, 20 X 30, FIRM MESH, SURGICAL FTM SP100043

Patients

Seq Age Sex Outcome Treatment
1 59 YR Female Required Intervention NO.