(b)(4).Method of evaluation: actual device not evaluated - the device was not returned for evaluation.It was not specified if the device was explanted along with the implant.The lot associated with this event remains unknown; therefore a review of the device history records could not be performed.Device not returned.Device failure related to patient condition.Based on the limited information, a relationship between the event and the strattice device could not be determined.The event is likely related to patient condition and unlikely related to strattice.As the literature review reveals, in 22 out of 23 of these cases, the wounds were considered at least contaminated prior to mesh closure.It should be noted that disintegration of the device is not a malfunction when the device is exposed to deleterious substances such as bacterial contamination, or interstitial fluids.Exposure of the device to these substances may be caused by iatrogenic injury, post operative complications, and co-morbid conditions unrelated to the device itself.If additional information is reported, a follow up report will be submitted.
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During a literature review performed on (b)(6) 2017, a publication titled "the biologic prosthesis is a viable option for abdominal wall reconstruction in pediatric high risk defects" reported that a retrospective chart review was performed of all cases of abdominal wall reconstruction in a single institution (children's hospital los angeles) between january 2007 - february 2015.Overall there were a total of 23 patients who underwent abdominal wall reconstruction using a biological prosthesis including 17 neonates (0-28 days old) and non-neonates (6wks to 19 years).In 22 cases, the wounds were considered at least contaminated or infected prior to mesh closure.This complaint is associated with patient #13 in table 1 of the article implanted with strattice.Patient #13 was(b)(6) with a diagnosis of omphalocele.Primary skin closure was not achieved following ab wall reconstruction with strattice.Complication reported was sloughed mesh and reherniation.
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