FDA Adverse Event Injury Summary report: N

PROCEED MULTI-LAYER LAMINATE MESH

MDR report key: 728759 · Received June 26, 2006

Report

Report Number
2210968-2006-00445
Event Type
Injury
Date Received
June 26, 2006
Report Date
January 15, 2006
Manufacturer
ETHICON, INC.
Product Code
FTL
PMA / PMN Number
K031925
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

H6: CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. 510K#:K031925.

Description of Event or Problem · 1

SURGEON REPORTS THAT THE PATIENT'S BOWEL WAS FOUND TO BE COMPLETELY ADHERED TO THE PLOYPROPYLENE LAYER OF PROCEED MESH APPROXIMATELY 4 MONTHS POST IMPLANTATION. THE PATIENT DEVELOPED A BOWEL FISTULA AND SUBSEQUENT INFECTION. THE PATIENT WAS RETURNED TO SURGERY WHERE THE MESH WAS EXCISED AND REPLACED WITH A COMPETITIVE PRODUCT. THE PATIENT IS REPORTED AS WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROCEED MULTI-LAYER LAMINATE MESH MESH, SURGICAL, POLYMERIC FTL ETHICON, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention