FDA Adverse Event Injury Summary report: N

MESO BIOMATRIX ACELLULAR PERITONEUM MATRIX

MDR report key: 5470915 · Received March 1, 2016

Report

Report Number
2530154-2016-00002
Event Type
Injury
Date Received
March 1, 2016
Date of Event
December 4, 2015
Report Date
March 1, 2016
Manufacturer
DSM BIOMEDICAL
Product Code
OXH
PMA / PMN Number
K094061
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF THE DEVICE HISTORY RECORDS DOES NOT HAVE DEVIATIONS THAT WOULD CONTRIBUTE TO THE REPORTED COMPLICATIONS. THE PRODUCT MET ALL PRE-DETERMINED ACCEPTANCE CRITERIA. REVIEW OF STERILIZATION RECORDS INDICATE THE PRODUCT WAS PROCESSED IN ACCORDANCE WITH PRODUCT REQUIREMENTS AND MET ALL PRE-DETERMINED ACCEPTANCE CRITERIA FOR STERILITY. THE CAUSE OF THE COMPLICATION CAN NOT BE DETERMINED FROM THE PROVIDED INFORMATION OR THE MANUFACTURING RECORDS. DEVICE DISCARDED AT HOSPITAL.

Description of Event or Problem · 1

A FEMALE PATIENT HAD BILATERAL MASTECTOMY FOLLOWED BY IMMEDIATE SINGLE STAGE, BILATERAL BREAST RECONSTRUCTION WITH 320CC TEXTURED, SILICONE GEL BREAST IMPLANTS. MESO BIOMATRIX WAS IMPLANTED IN EACH BREAST . APPROXIMATELY 2 MONTHS LATER, THE LEFT BREAST WAS OBSERVED TO HAVE 'THIN SKIN.' SHE WAS STARTED ON INTRAVENOUS ANTIBIOTICS AND THE THIN SKIN WAS EXCISED AND CLOSED. ON THE FOLLOWING DAY, THE WOUND WAS REPORTEDLY HEALING. HOWEVER, 4 DAYS LATER, THE LEFT BREAST WOUND DEHISCED AND THE IMPLANT WAS VISIBLE. THE RIGHT BREAST ALSO HAD AN INFECTED APPEARANCE. THE PATIENT DECIDED TO HAVE BOTH IMPLANTS REMOVED. SO THAT SAME DAY, THE IMPLANTS AND MESO BIOMATRIX WERE REMOVED BILATERALLY. AT THE TIME OF EXPLANTATION, THE SURGEON NOTED THE MESO BIOMATRIX TO BE THIN AND BARELY RECOGNIZABLE. INTRAVENOUS ANTIBIOTICS WERE CONTINUED FOR 24 HOURS, FOLLOWED BY ORAL ANTIBIOTICS FOR 5 DAYS. THE DEHISCENCE WERE REPORTED TO HAVE RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
126465 MESO BIOMATRIX ACELLULAR PERITONEUM MATRIX MESH, SURGICAL, COLLAGEN, PLASTIC AND RECONSTRUCTIVE SURGERY OXH DSM BIOMEDICAL 30055-06 C0767

Patients

Seq Age Sex Outcome Treatment
1 30 YR Required Intervention