BEUDAMED
    FDA Adverse Event Death Summary report: N

    DAVOL BARD HERNIA MESH 10 X 14 #0112660

    MDR report key: 4992702 · Received August 6, 2015

    Report

    Report Number
    MW5055252
    Event Type
    Death
    Date Received
    August 6, 2015
    Date of Event
    June 20, 2011
    Report Date
    August 5, 2015
    Manufacturer
    DAVOL BARD
    Product Code
    FTL
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 0

    DAVOL BARD MESH PLACED DURING (B)(6) 2000, HERNIA REPAIR FAILED IN (B)(6) 2011. SURGERY TO REMOVE MESH WAS COMPLICATED BY MESH ADHERING TO BOWEL AND SURROUNDING ORGANS. REMOVAL OF MESH RESULTED IN PERFORATION TO BOWEL, SEPSIS, AND DEATH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    519851 DAVOL BARD HERNIA MESH 10 X 14 #0112660 DAVOL BARD HERNIA MESH 10 X 14 #0112660 FTL DAVOL BARD 0112660 43JJA258

    Patients

    Seq Age Sex Outcome Treatment
    0 65 YR Death CRESTOR