FDA Adverse Event Injury Summary report: N

NOVOSORB BTM

MDR report key: 22791174 · Received August 13, 2025

Report

Report Number
3007886187-2025-00021
Event Type
Injury
Date Received
August 13, 2025
Manufacturer
POLYNOVO BIOMATERIALS PTY LTD
Product Code
QSZ
PMA / PMN Number
K172140
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
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. 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. THE REPORTED ISSUE IS A KNOWN RISK ASSOCIATED WITH THE USE OF THE DEVICE. BASED ON THE INFORMATION RECEIVED, THE ROOT CAUSE OF THE REPORTED EVENT COULD NOT BE CONCLUSIVELY IDENTIFIED. 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 FOLLOWING A SUCCESSFUL BTM INTEGRATION IN CONJUNCTION WITH THE SECONDARY SPLIT-THICKNESS SKIN GRATING (STSG), THE PATIENT PRESENTED AT ONE-YEAR POST-OP WITH SIGNIFICANT SCAR CONTRACTURE OF THE NECK RESULTING IN FUNCTIONAL IMPAIRMENT OF DAILY ACTIVITIES. PER REPORT, THE STSG WAS PERFORMED NINETEEN (19) DAYS AFTER BTM PLACEMENT. ANY OMITTED INFORMATION WAS NOT AVAILABLE AT THE TIME OF THIS REPORT. PLEASE REFERENCE HTTPS://DOI.ORG/10.1016/J.BJPS.2025.07.001.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
62268 NOVOSORB BTM Absorbable synthetic wound dressing QSZ POLYNOVO BIOMATERIALS PTY LTD

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention