Based upon additional information received on 22-nov- 2017, the case became valid as the serious event of device malfunction with the seriousness criterion of important medical event was added and the case initially assessed as non-serious was also upgraded to serious.This case was cross referenced with (b)(4) (cluster).This unsolicited case from united states was received on 21-nov-2017 from the health care professional.This case concerns 3 patients (age and gender unspecified) who received treatment with synvisc one injection and after unknown latencies the patients experienced adverse reactions; also, device malfunction was identified for the reported lot number.No relevant medical history, past medications and concomitant medications were reported.On unknown dates, the patients received treatment with intra-articular synvisc one injection, once (dose, indication: not reported; lot number: 7rsl021 expiration date: 31-may-2020).On unknown dates, unknown latencies of receiving the injection the patients experienced adverse events.Action taken: unknown.Corrective treatment: not reported.Outcome: unknown.A pharmaceutical technical complaint (ptc) was initiated with global ptc number: (b)(4).An investigation was initiated as a result of an unexpected increase in the number of labelled adverse events received from the us market for synvisc one lot 7rsl021.The product met all release testing at time of manufacture in june 2017.Retain samples were retested due to the unexpected increase in adverse events.Higher than expected endotoxin results were obtained.In addition, the presence of microbial contamination was also confirmed.The cause of these events was under investigation.Once this investigation would be completed, corrective and preventive actions would be implemented.Seriousness criterion: important medical event (ime) for device malfunction.Follow up information was received on 04-dec-2017.No new information was received.Additional information was received on 22-nov-2017.The serious event of device malfunction with the seriousness criterion of ime was added and the case became valid and was upgraded to serious.The gptc results were added.Text amended accordingly.Pharmacovigilance comment: sanofi follow-up company comment dated 22-nov-2017: this case concerns a patient who received treatment with synvisc one and later experienced adverse events.A temporal relationship can be established with the product administration.Also, the concerned lot number has been identified to have malfunction by the company.Thus, the causal relationship of the events to the products cannot be excluded.
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