FDA Adverse Event Injury Summary report: N

CONTIGEN® BARD® COLLAGEN IMPLANT

MDR report key: 5015942 · Received August 19, 2015

Report

Report Number
1018233-2015-00296
Event Type
Injury
Date Received
August 19, 2015
Report Date
July 27, 2015
Manufacturer
C.R. BARD, INC. (COVINGTON) -1018233
Product Code
LNM
PMA / PMN Number
P900030
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE WAS NOT RETURNED. THE FINISHED PRODUCT MET ALL SPECIFICATIONS PRIOR TO BEING RELEASED FOR GENERAL DISTRIBUTION. THE INSTRUCTIONS FOR USE WHICH ACCOMPANIES ALL DEVICES CURRENTLY ADDRESSES POTENTIAL RISKS ASSOCIATED WITH SURGICALLY IMPLANTED MATERIALS. THE INSTRUCTIONS FOR USE STATES IN THE ADVERSE EVENTS: UROLOGICAL APPLICATIONS. ADVERSE EVENTS ASSOCIATED WITH TREATMENT MAY INCLUDE BUT ARE NOT LIMITED TO: WORSENED INCONTINENCE; URINARY RETENTION; URINARY TRACT INFECTION; AND/OR LOCALIZED RESPONSES (INCLUDING SWELLING, ERYTHEMA, INDURATION, INFECTION, NECROSIS, ABSCESS FORMATION, AND/OR HYPERSENSITIVITY RESPONSE). SLIGHT DISCOMFORT AND MILD BLEEDING WILL PROBABLY OCCUR AT THE INJECTION SITE IMMEDIATELY FOLLOWING THE INJECTION PROCEDURE. IN THE CLINICAL EVALUATION, APPROXIMATELY 2% OF TREATED PATIENTS REPORTED PAIN AT THE INJECTION SITE OR INJECTION SITE INJURY. TRANSIENT GROSS HEMATURIA MAY OCCUR IMMEDIATELY FOLLOWING THE INJECTION PROCEDURE. IN THE CLINICAL EVALUATION OF CONTIGEN IMPLANT, POSTPROCEDURE HEMATURIA OCCURRED IN APPROXIMATELY 2% OF TREATED PATIENTS. THE PATIENT SHOULD BE TOLD TO REPORT INCREASING DISCOMFORT OR SWELLING TO THE PHYSICIAN. (B)(4). THE INFORMATION PROVIDED BY BARD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BARD. NO SAMPLE RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED IN THE PATIENT'S MEDICAL RECORDS THAT AS A RESULT OF HAVING THE PRODUCT IMPLANTED, THE PATIENT HAS EXPERIENCED PAIN, EXTRUSION, UNSPECIFIED URINARY PROBLEMS, ORGAN PERFORATION, RECURRENCE, DYSPAREUNIA, VAGINAL SCARRING (SCARRING), EROSION, INFECTION, UNSPECIFIED BOWEL PROBLEMS, ADHESIONS, URINARY STRESS INCONTINENCE, INTERNAL SPHINCTER DEFICIENCY, CYSTOCELE (PROLAPSE), ENTEROCELE, CHRONIC INTERSTITIAL CYSTITIS (INFLAMMATION), SUPRAPUBIC/ABDOMINAL PAIN (ABDOMINAL PAIN), LUMBAGO, URINARY FREQUENCY, URINARY URGENCY, DYSURIA, BLADDER CALCULUS, FOREIGN BODY IN BLADDER (FOREIGN BODY IN PATIENT), ULCERATIVE COLITIS (ULCERATION), CALCIFICATION, ALLERGIES, ABNORMAL GAIT, OVERDOSE, PARTIAL SMALL BLADDER OBSTRUCTION (OBSTRUCTION), INFLAMMATORY MASS IN COLON, STRICTURES, SCAR TISSUE, MIXED PORTAL INFLAMMATION, INTERLOBULAR BILE DUCT INJURY, PERIDUCTAL HISTIOCYTES, STEATOHEPATITIS/STEATOSIS, PERISINUSOIDAL/PORTAL/SEPTAL FIBROSIS (FIBROSIS), ELEVATED LIVER FUNCTION STUDIES, ACUTE AND CHRONIC SEROSITIS, LYMPH NODE REACTIVE CHANGES, CHOLELITHIASIS, ADENOMYOSIS OF GALLBLADDER WALL, BLOOD LOSS, AND REQUIRED ADDITIONAL SURGICAL AND NON-SURGICAL INTERVENTIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
549122 CONTIGEN® BARD® COLLAGEN IMPLANT CONTIGEN® BARD® COLLAGEN IMPLANT LNM C.R. BARD, INC. (COVINGTON) -1018233 CVQH0029

Patients

Seq Age Sex Outcome Treatment
1 42 YR Required Intervention