FDA Adverse Event Death Summary report: N

SYMBOTEX

MDR report key: 6954609 · Received October 17, 2017

Report

Report Number
9615742-2017-05555
Event Type
Death
Date Received
October 17, 2017
Report Date
March 23, 2026
Manufacturer
SOFRADIM PRODUCTION SAS
Product Code
FTL
UDI-DI
10884521190412
PMA / PMN Number
K142908
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
ATTORNEY
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: B5, D8, E1 (INITIAL REPORTER: FACILITY NAME, STREET 1, CITY, REGION, POSTAL CODE), H6 (PATIENT AND IMF CODES) MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: B5, B7, D4 (UDI #), G4 (510K #), H6 (DEVICE CODES, REMOVED PATIENT CODE). MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

THE PATIENT¿S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. THE PRODUCT WAS USED FOR THERAPEUTIC TREATMENT OF A RECURRENT VENTRAL HERNIA IN A LAPAROSCOPIC REPAIR. IT WAS REPORTED THAT AFTER IMPLANT, THE PATIENT EXPERIENCED RECURRENCE, MESH RETRACTION, EMOTIONAL DISTRESS, AND ADHESIONS. POST-OPERATIVE PATIENT TREATMENT INCLUDED REVISION SURGERY, LYSIS OF ADHESIONS, CT SCAN, REPAIR OF HERNIA WITH MESH, AND LAPAROSCOPIC CLOSURE OF THE FASCIA DEFECT. IT HAS SINCE BEEN REPORTED THAT THE PATIENT HAD EXPIRED. INFORMATION REGARDING THE DATE AND CAUSE OF DEATH IS UNAVAILABLE.

Description of Event or Problem · 0

THE PATIENT¿S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. THE PRODUCT WAS USED FOR THERAPEUTIC TREATMENT OF A RECURRENT VENTRAL HERNIA IN A LAPAROSCOPIC REPAIR. IT WAS REPORTED THAT AFTER IMPLANT, THE PATIENT EXPERIENCED MESH MIGRATION, MESH SHRINKAGE, PAIN, SUFFERING, DEFECTIVE MESH, RECURRENCE, MESH RETRACTION, EMOTIONAL DISTRESS, ADHESIONS AND DEATH. POST-OPERATIVE PATIENT TREATMENT INCLUDED MESH REVISION, REVISION SURGERY, LYSIS OF ADHESIONS, CT SCAN, REPAIR OF HERNIA WITH MESH, AND LAPAROSCOPIC CLOSURE OF THE FASCIA DEFECT. INFORMATION RECEIVED INDICATES THE PATIENT IS DECEASED. NO INFORMATION WAS PROVIDED REGARDING THE CIRCUMSTANCES OF EXPIRATION.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

THIS INFORMATION WAS RECEIVED AS A PART OF AN EXTENSIVE MESH LITIGATION SUBMISSION TO MEDTRONIC. THE FDA WAS NOTIFIED OF THIS LARGE COMPLAINT RECEIPT. DUE TO THE VOLUME OF COMPLAINT INFORMATION RECEIVED BY MEDTRONIC, THIS RESULTED IN A REPORT BEYOND THE 30 DAY TARGET. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

THIS INFORMATION WAS RECEIVED AS A PART OF AN EXTENSIVE MESH LITIGATION SUBMISSION TO MEDTRONIC. THE FDA WAS NOTIFIED OF THIS LARGE COMPLAINT RECEIPT. DUE TO THE VOLUME OF COMPLAINT INFORMATION RECEIVED BY MEDTRONIC, THIS RESULTED IN A REPORT BEYOND THE 30 DAY TARGET. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

(B)(4) - REVISION SURGERY. A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

THE PATIENT¿S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. THE PRODUCT WAS USED FOR THERAPEUTIC TREATMENT OF A RECURRENT VENTRAL HERNIA. IT WAS REPORTED THAT AFTER IMPLANT, THE PATIENT EXPERIENCED RECURRENCE. IT HAS SINCE BEEN REPORTED THAT THE PATIENT HAD EXPIRED. INFORMATION REGARDING THE DATE AND CAUSE OF DEATH IS UNAVAILABLE. IT IS UNKNOWN AT THIS TIME IF THE DEVICE CAUSED OR CONTRIBUTED TO THE EVENT.

Description of Event or Problem · 1

THE PATIENT¿S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. THE PRODUCT WAS USED FOR THERAPEUTIC TREATMENT OF A RECURRENT VENTRAL HERNIA. IT WAS REPORTED THAT AFTER IMPLANT, THE PATIENT EXPERIENCED RECURRENCE, MESH RETRACTION, AND ADHESIONS. POST-OPERATIVE PATIENT TREATMENT INCLUDED REVISION SURGERY, LYSIS OF ADHESIONS, REPAIR OF HERNIA WITH MESH, AND LAPAROSCOPIC CLOSURE OF THE FASCIA DEFECT. IT HAS SINCE BEEN REPORTED THAT THE PATIENT HAD EXPIRED. INFORMATION REGARDING THE DATE AND CAUSE OF DEATH IS UNAVAILABLE.

Description of Event or Problem · 1

THE PATIENT¿S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. THE PRODUCT WAS USED FOR THERAPEUTIC TREATMENT OF A RECURRENT VENTRAL HERNIA IN A LAPAROSCOPIC REPAIR. IT WAS REPORTED THAT AFTER IMPLANT, THE PATIENT EXPERIENCED RECURRENCE, MESH RETRACTION, AND ADHESIONS. POST-OPERATIVE PATIENT TREATMENT INCLUDED REVISION SURGERY, LYSIS OF ADHESIONS, REPAIR OF HERNIA WITH MESH, AND LAPAROSCOPIC CLOSURE OF THE FASCIA DEFECT. IT HAS SINCE BEEN REPORTED THAT THE PATIENT HAD EXPIRED. INFORMATION REGARDING THE DATE AND CAUSE OF DEATH IS UNAVAILABLE.

Description of Event or Problem · 1

THE PATIENT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE RESULTING IN AN UNSPECIFIED ADVERSE OUTCOME. PRODUCT WAS USED FOR THERAPEUTIC TREATMENT. THE PATIENT HAS HAD A MESH UNINCORPORATED, RETRACTED IN INFERIOR AND SUPERIOR ASPECT. MESH COMPLETELY COVERED BY OMENTAL ADHESIONS. THE PATIENT HAD A REVISION SURGERY APPROXIMATELY 1 YEAR AND 6 MONTHS POST OP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
581276 SYMBOTEX MESH, SURGICAL, POLYMERIC FTL SOFRADIM PRODUCTION SAS SYM1710E PNJ0227X 10884521190412

Patients

Seq Age Sex Outcome Treatment
1 NA Male Required Intervention| O| D