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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: C.R. BARD, INC. (COVINGTON) -1018233 AVAULTA SOLO® SYNTHETIC SUPPORT SYSTEM - POSTERIOR

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C.R. BARD, INC. (COVINGTON) -1018233 AVAULTA SOLO® SYNTHETIC SUPPORT SYSTEM - POSTERIOR Back to Search Results
Catalog Number 486200
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Abdominal Pain (1685); Autoimmune Disorder (1732); Erosion (1750); Cyst(s) (1800); Fibromyositis (1860); High Blood Pressure/ Hypertension (1908); Incontinence (1928); Nausea (1970); Nerve Damage (1979); Neuropathy (1983); Urinary Retention (2119); Blurred Vision (2137); Dysphasia (2195); Hernia (2240); Urinary Frequency (2275); Anxiety (2328); Arthralgia (2355); Depression (2361); Sore Throat (2396); Numbness (2415); Diaphoresis (2452); Shaking/Tremors (2515); Dysuria (2684); Constipation (3274); Vitamin Deficiency (4497); Genital Bleeding (4507); Cramp(s) /Muscle Spasm(s) (4521); Urinary Incontinence (4572); Swelling/ Edema (4577)
Event Type  Injury  
Event Description
It was reported in the patient¿s medical records that as a result of having the product implanted, the patient has experienced hypertension, ¿spells¿ (face and eyes feel puffy, top of mouth gets big and dentures don¿t fit, neck gets flushed-patient attributes to mesh), ¿jitters,¿ ¿apprehension,¿ anxiety, ¿burping and gas,¿ diagnosed with empty sella syndrome ((b)(6) 2011), multiple symptoms attributed by patient to mesh implant surgery on (b)(6) 2009 (¿eyes watering and squinty; feels uneven, which appears to be related to decreased balance; teeth feel foreign; lower back pain, constant pressure in face; back of head hurts; neck gets tight; patient gets cold [especially hands, which get cold, numb, and splotchy]; stomach hurts; dizziness (vertigo); lightheadedness; feeling drained and tired; constant runny nose; choking or gagging at times; stomach bloated; muscles in body will tighten and release; bruises easily; sour taste and bad breath; swelling that comes and goes; nausea; if she does not have a bowel movement when she feels the urge, she will develop tenesmus where her anal sphincter shuts down and she cannot go until the next day; occasional tinnitus; hurts to chew; feels short of breath when her muscles are tight; and pain rated 8/10 that keeps her from playing with grandchildren); polymyalgia etiology unknown, dyspepsia suggestive of gastroesophageal reflux disease, more frequent migraines (¿since mesh surgery¿), ¿vague-like symptoms like inability to feel her veins and they do not pop up like they used to,¿ whole-body weakness, cramps in lower extremities, bilateral essential tremor of upper extremities, cold intolerance, peripheral edema with her legs numb to her mid-calf and her hands numb just above her wrist in a stocking glove distribution, ¿feels wound-up on the inside,¿ fibromyalgia, peripheral neuropathy, smoker (quit (b)(6) 2013), unspecified myalgia and myositis, probable autoimmune disease, elevated catecholamines and metanephrines, diffuse pain, arthralgias, dysuria, pelvic pain, ¿sex impossible due to severe pain,¿ weight gain, hypercholesterolemia, mild urge, urinary frequency attributed to drinking a lot, urge urinary incontinence, anterior and posterior vaginal tenderness, ¿mesh bunched and contracted,¿ ¿mesh embedded in the vaginal wall in two spots at the apex where small buttonholes of the vagina had to be removed¿ ((b)(6) 2013), ¿cystocele stage 3,¿ stress incontinence status-post sling,¿ mesh eroded into urethra (nearly full-thickness perforation; (b)(6) 2013), ¿rectocele¿ ((b)(6) 2013), postoperative episode of orthostatic hypotension (40/20; (b)(6) 2013), postoperative nausea and vomiting ((b)(6) 2013), recurrent stage 3 cystocele ((b)(6) 2013), recurrent rectocele ((b)(6) 2014), mesh significantly bunched at the apex with a tight band ((b)(6)2014), ¿few small vaginal perforations where mesh was very superficial¿ ((b)(6) 2014), chronic pelvic pain and vaginal area pain, severe frequency of urination, urgency, mesh erosion, recurrence of prolapse, urinary retention, suffered psychologically and emotionally, and loss of physical activity after undergoing an anterior and posterior repair with mesh and transobturator tape sling ((b)(6) 2009), a loss of consortium claim was also filed, patient ¿had suffered, may have suffered, or presently did suffer from¿ diverticulitis, erosion of pelvic, urethral, and bladder tissue; vaginal pain-muscle constrictions, chronic functional constipation requiring laxatives, removal of mesh sling, removal of anterior mesh kit, pubovaginal sling with allograft, anterior repair reinforced with allograft 6 x 8 cm using six-point fixation, washout, cystoscopy, and urethrorrhaphy ((b)(6) 2013); transvaginal removal of polypropylene mesh implant, posterior repair using plication technique, irrigation and washout protocol ((b)(6) 2014); transurethral injection ((b)(6)2014).Per additional information received, the patient has experienced drainage, rectocele/cystocele stage three (prolapse), painful mesh, pelvic pain, constipation, migraines, weakness, unable to have sex, pain with sex, weight gain, hypertension, hypercholesterolemia, frequency, urgency, urge urinary incontinence, urethral perforation/erosion/buttonholes, urethral defect, hypotension, dehydration, flushing, lightheaded (dizziness), blood loss, bloody vaginal output, dysuria, hematuria, mesh bunched at apex, tight band, vaginal wall perforations and nonsurgical and additional surgical interventions.Per additional information received via medical records on 10/11/2017, the patient has experienced neurological issues, constipation, weakness, bowel irritation, lower abdominal symptoms, pain with sex, disability due to fmr, migraines since pop surgery, never returned to work, urge urinary incontinence, recurrent rectocele, recurrent cystocele, urethral pain, pelvic pain, stress urinary incontinence, mesh erosion into the urethra, vaginal pain, rectal pain, intrinsic sphincter deficiency, and has required three surgical interventions consisting of two explant and revision surgeries on (b)(6) 2013 and (b)(6) 2014, requiring fascia tutoplast and floseal placement during 11/12/13 revision and an injection of macroplastique on (b)(6) 2014.Per additional information received via medical records on 01jun2023, the patient experienced hyperparathyroidism, dysphagia, facial flushing, fibromyalgia, diffuse muscle spasms, numbness in hand and feet, upper and lower abdominal pain, chronic narcotics, migraines, peripheral neuropathy, monoclonal gammopathy, dyslipidemia, poor bowel control, nausea, emesis, high normal calcium level, blood in stool, hematemesis, dysphagia, icterus, nausea/vomiting, change in bowel habits, loose stools, dysuria, urinary frequency, incontinence, nocturia, change in gait or difficulty walking, easy bruising, excessive bleeding, recurrent laryngeal nerve injury, myositis, legs swelling, muscle aches, hypertension, depression, essential tremor, gerd, hypotensive episode, hiatal hernia esophageal dilatation, catecholamine levels increased, elevated metanephrines, left posterior scalp mass, autoimmune thyroid disease, clinical concern for pheochromocytoma, bloating, elevated crp, scalp cysts, neurological issues, multiple sclerosis, bowel irritation, tremor, blurry vision, sore throat, unspecified vitamin ¿ d deficiency, cystocele, rectocele, constipation, stress urinary incontinence, acne vulgaris, complications of genitourinary device, painful intercourse, weight gain and htn, hypercholesterolemia, urethral perforation or erosion, urinary incontinence, urinary retention, injury to sciatic nerve or pelvic nerves such as the pudendal nerve, graft complication, recurrent rectocele, menopausal syndrome, poor bowel control, positive ana, musculoskeletal pain, burping and passing a lot of gas, empty sella syndrome, diaphoresis, palpitations, arthralgias, jitters, apprehension, anxiety, mesh erosion and the required nonsurgical and additional surgical interventions.
 
Manufacturer Narrative
The reported event could not be confirmed.No sample was returned for evaluation and the lot number is unknown.Based on the investigation findings, current manufacturing controls are considered adequate as to detect and segregate any non-conforming unit.Event described could not be confirmed as a manufacturing related issue.The alleged event is most likely associated with possible procedural/surgical complications.The lot number is unknown; therefore, the device history record could not be reviewed.The ifu currently addresses potential risks associated with surgically implantable materials which states the following: adverse reactions: potential adverse reactions are those typically associated with surgically implantable materials, including hematoma, seroma, mucosal or visceral erosion, infection, inflammation, sensitization, dyspareunia, scarification and contraction, fistula formation, extrusion and recurrence of vaginal wall prolapse.Perforations or lacerations of vessels, nerves, bladder, bowel, rectum, or any viscera may occur during needle passage.Precautions: caution: federal (usa) law restricts this device to sale by or on the order of a physician.Avaulta solo¿ support system should only be used by physicians who are trained in the surgical procedures and techniques required for pelvic floor reconstruction and the implantation of nonabsorbable meshes.Acceptable surgical practices should be followed for the management of infected or contaminated wounds.Avaulta solo¿ support system implantation procedures require diligent attention to anatomical structure and care to avoid puncture of large vessels, nerves, bladder, bowel, rectum, or other viscera during needle passage.The avaulta solo¿ support system is provided in a sterile blister tray within a sterile pouch.The sterile blister tray may be placed in the sterile field.The introducers provided with the anterior and posterior support systems are provided in a sterile blister tray.Transfer the introducer to the sterile field using aseptic techniques.Do not place the tray in the sterile field.Check the integrity of the packaging before use.Do not use the mesh or introducers if the packaging is opened or damaged.As for any implantable material, it is recommended to open the blister tray at the time of implantation.After use, any unused product and packaging should be treated as a potential biohazard.Handle and dispose of in accordance with accepted medical practice and applicable local, state, and federal laws and regulations.2120, 1750, 2475, 1994 ="l".2348, 2558, 2371, 2329, 1908, 2328, 2415, 2194, 2134, 1754, 2091, 1970, 2194 2134, 1754, 2091, 2145, 2193, 1820, 1983, 2238, 2607, 1871, 2119, 2564, 1880, 2597, 1941, 1966, 2240, 2102, 2137, 1800, 2467="nl".H11:section a through f - the information provided by bd 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 bd.H3 other text : the device was not returned.
 
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Brand Name
AVAULTA SOLO® SYNTHETIC SUPPORT SYSTEM - POSTERIOR
Type of Device
AVAULTA SOLO® SYNTHETIC SUPPORT SYSTEM - POSTERIOR
Manufacturer (Section D)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington GA 30014
Manufacturer (Section G)
C.R. BARD, INC. (COVINGTON) -1018233
8195 industrial blvd
covington GA 30014
Manufacturer Contact
xeeroy rada
8195 industrial blvd
covington, GA 30014
7707846100
MDR Report Key17181306
MDR Text Key317646669
Report Number1018233-2023-090006
Device Sequence Number1
Product Code OTP
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K082571
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 06/22/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received06/22/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Expiration Date05/31/2011
Device Catalogue Number486200
Device Lot NumberHUTD1818
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Device Age4 MO
Event Location Hospital
Date Manufacturer Received06/01/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured05/18/2009
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
ALIGN® TO URETHRAL SUPPORT SYSTEM - HOOK + HALO; AVAULTA SOLO® SYNTHETIC SUPPORT SYSTEM - ANTERIOR
Patient Outcome(s) Required Intervention;
Patient Age54 YR
Patient SexFemale
Patient Weight54 KG
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