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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SOFRADIM PRODUCTION PCO VENTRAL PATCH 6C; PARIETEX MESH

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SOFRADIM PRODUCTION PCO VENTRAL PATCH 6C; PARIETEX MESH Back to Search Results
Catalog Number PCO6VP
Device Problems Crack (1135); Defective Component (2292)
Patient Problem No Information (3190)
Event Date 02/25/2014
Event Type  malfunction  
Event Description
Procedure: demo.According to the reporter: after a defective device was opened at one of my accounts, we opened another one (pco4vp lot number rne9997) and the barrier did the same thing.It was very brittle and snapped off by touching it.There was also a very large piece that cracked off.It was very brittle.I opened several of my demo pieces and some were far more brittle than others and really "cracked" when touching them.Some were fine.The following samples will be sent in for evaluation: pco4vp lot number rne9997 pco4vp lot number pnj0295 pco4vp lot number pnk0116 pco6vp lot number pnj0282.After the incident at the hospital i wanted to check my demo products and all of the above came from my demo.They may have been subjected to very cold temperatures either in transit to me or in my trunk and i am curious if this has anything to do with the "brittleness" of them.
 
Manufacturer Narrative
(b)(4).
 
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Brand Name
PCO VENTRAL PATCH 6C
Type of Device
PARIETEX MESH
Manufacturer (Section D)
SOFRADIM PRODUCTION
116 avenue du formans
trevoux F-01 600
FR  F-01600
Manufacturer (Section G)
SOFRADIM PRODUCTION
116 avenue du formans
trevoux F-01
FR   F-01
Manufacturer Contact
sharon murphy
60 middletown ave.
north haven, CT 06473
2034925267
MDR Report Key3738044
MDR Text Key4278325
Report Number9615742-2014-00113
Device Sequence Number1
Product Code FTL
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K120506
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Other
Type of Report Initial
Report Date 02/25/2014
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/11/2014
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Expiration Date10/31/2018
Device Catalogue NumberPCO6VP
Device Lot NumberPNJ0282
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Date Manufacturer Received02/25/2014
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/01/2013
Is the Device Single Use? Yes
Type of Device Usage Initial
Patient Sequence Number1
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