BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NOVOSORB MTX

    MDR report key: 22746304 · Received August 8, 2025

    Report

    Report Number
    3007886187-2025-00020
    Event Type
    Injury
    Date Received
    August 8, 2025
    Date of Event
    July 3, 2025
    Report Date
    August 8, 2025
    Manufacturer
    POLYNOVO BIOMATERIALS PTY LTD
    Product Code
    QSZ
    PMA / PMN Number
    K221686
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AS
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THE DEVICE WAS NOT AVAILABLE AND THEREFORE A DEVICE EVALUATION COULD NOT BE PERFORMED. A DEVICE HISTORY RECORD REVIEW WAS UNABLE TO BE COMPLETED AS A LOT NUMBER WAS NOT PROVIDED. A HIGH-LEVEL ANALYSIS WAS PERFORMED AND THERE WERE NO NON-CONFORMITIES FOUND TO BE RELATED TO THE REPORTED EVENT. BASED ON THE INFORMATION RECEIVED, THE ROOT CAUSE OF THE REPORTED GRAFT LOSS EVENT COULD NOT BE CONCLUSIVELY DETERMINED. HOWEVER, SKIN GRAFT FAILURE IS A KNOWN ADVERSE OUTCOME THAT MAY OCCUR POST BTM INTEGRATION, AND IS A RECOGNISED COMPLICATION ASSOCIATED WITH STANDARD APPLICATION ONTO VIABLE TISSUE. A REVIEW OF THE DEVICE¿S RISK PROFILE SUGGESTS THE REPORTED EVENT DOES NOT CONSTITUTE A NEW HARM OR HAZARD. AN ADVERSE EVENT APPEARS TO HAVE OCCURRED BUT DOES NOT APPEAR TO HAVE BEEN A PROBLEM WITH THE DEVICE OR THE WAY IT WAS USED BASED ON THE INFORMATION RECEIVED. THE IFU ADEQUATELY PROVIDES INSTRUCTIONS FOR IMPLANTATION, PRECAUTIONS, AND WARNINGS FOR THE PROPER USE AND HANDLING OF THE DEVICE. POLYNOVO COULD NOT CONFIRM A DETERIORATION OR CHANGE IN THE CHARACTERISTICS OR PERFORMANCE, OR INACCURACIES IN THE LABELLING OR INSTRUCTION FOR THE REPORTED CASE. THE RATE OF THE REPORTED ISSUE TO POLYNOVO IS CONSIDERED LOW AND ACCEPTABLE. THE CLINICAL BENEFITS CONTINUE TO OUTWEIGH THE POTENTIAL RISKS ASSOCIATED WITH THIS HAZARD/USE OF THE DEVICE. NO TREND OR DEFICIENCY HAS BEEN IDENTIFIED. POLYNOVO DOES NOT BELIEVE THAT A CORRECTIVE ACTION IS WARRANTED. POLYNOVO WILL CONTINUE TO INVESTIGATE AND MONITOR COMPLAINTS OF THIS NATURE. MFR REFERENCE #: (B)(4).

    Description of Event or Problem · 0

    IT WAS REPORTED THAT AFTER IMPLANTATION AND INTEGRATION OF MTX, THE WOUND WAS GRAFTED. THE GRAFT WAS LOST ONE WEEK POST GRAFT APPLICATION. THE SURGEON REGRAFTED THE WOUND BED THE FOLLOWING WEEK WITH A SUCCESSFUL OUTCOME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1243480 NOVOSORB MTX Absorbable synthetic wound dressing QSZ POLYNOVO BIOMATERIALS PTY LTD

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Female Required Intervention