Hypothyroid [hypothyroidism].Poor circulation [circulatory insufficiency].Its hard to ride bike [driving ability disturbed].Its hard to walk [difficulty in walking].Got all 3 injections at the same time on her left knee with no reported adverse event [off label use of device].Case narrative: initial information received on 06-jul-2021 regarding a solicited valid serious case received from a consumer/non-hcp, in the scope of patient support program "(b)(6)".Patient id: unknown; country: united states.Study title: sanofi patient connection.This case is linked to the cases (b)(6) (left knee), (b)(6) (right knee), (b)(6) (right knee), (b)(6) (left knee), and (b)(6) (left knee) (multiple device suspect used for the same patient); (b)(6) (left knee; duplicate) and (b)(6) (right knee; duplicate).This case involves a 67 years old female patient who got all 3 injections at the same time on her right knee with no reported adverse event and experienced hypothyroid, poor circulation and its hard to walk and to ride bike, while being treated with hylan g-f 20, sodium hyaluronate [synvisc].The patient's past medical treatment(s), vaccination(s) and family history were not provided.It is unknown if the patient had any medical history, concomitant disease or risk factor.In 2016, the patient received synvisc (hylan g-f 20, sodium hyaluronate) injection (8 mg/ml) at dose of 3 injections of 2.25 ml each at the same time on her right knee (with an unknown strength, route, batch number and expiry date) for bilateral primary osteoarthritis of knee.Information regarding the batch number and expiry date was requested.The patient received the first and last injection of synvisc on both knees and had not had anything else since then.The consumer mentioned that she got all 3 injections at the same time on her left knee, and all 3 injection on her right knee at the same time (however were intended to be taken as 1 injection weekly).The consumer told the orthopedic doctor that she doesn't want to waste his time nor she wants him to waste her time.The consumer mentioned that it worked for her and it is the only one that works for her, and she could be a spokesperson for this injection.On an unknown date after unknown latency the patient was diagnosed hypothyroid (hypothyroidism; seriousness criteria: medically significant), poor circulation (cardiovascular insufficiency; seriousness criteria: medically significant), also stated that its hard to walk and ride her bike (gait disturbance) and (impaired driving ability; seriousness criteria: disability).It was also reported that the patient was applying to get another injection of the hylan g-f 20, sodium hyaluronate for both knees.At the time of the report, the synvisc is continued.The consumer mentioned that it took 5 years for it to wear down, and now it's worn down and she knows she needs it again.The consumer called in saying that she was looking to see if someone can help them with the serum.The consumer said that a representative from the company gave her the number and other resources to help her with her medication, to help maybe with the payments.The consumer said that she would not take anything else because she had tried other products and that doesn't work, and this was the only thing that works, and if that means that this would help her, why would she take something else? the consumer said she wanted this injection, but she could not understand how some people could get help when their income was limited, and their income was limited and they had a house payment, and she thought that there was something out there that the company could do.The consumer said that she used synvisc for bone on bone, but she's sure that with age, she had arthritis.No additional information available.It was unknown if the patient experienced any additional symptoms/events.Action taken: not applicable for all the events.Corrective treatment: not reported for all the events.Outcome: unknown for off label use of device; not recovered for all the events.Reporter causality: not reported for all the events.Company causality: not reportable for all the events a product technical complaint (ptc) was initiated on 06-jul-2021 for synvisc.Batch number: unknown; comet compliant id number: (b)(4).Sample status: not available.The product lot number was not provided; therefore, a batch record review was not possible.Based on the lack of information provided, no capa (corrective and preventive action) was required.It was the requirement to review all finished batch records for specification conformance prior to release.Any out of specification result was identified and mitigated through the ncr (non-conformance report) process.Sanofi global pharmacovigilance and epidemiology continuously monitors adverse event reports with or without lot numbers, and assesses possible associations with their corresponding product lot, as part of routine safety surveillance effort to detect safety signals.This review had not indicated any safety issue.An attempt was made to confirm the product name as it was more probable that the product in question was synvisc rather than synvisc one simply due to its volume.Unfortunately, intake was unable to confirm this with the complainant.This and the other 5 cases will be processed as they are.This investigation will be revised once more information becomes available.Sanofi would continue to monitor adverse events to determine if a capa was required final investigation complete date: 29-sep-2021 with summary code as no assessment possible.Additional information was received on 06-jul-2021 from the patient.Case initially assessed as non-case was upgraded to valid case.Text amended accordingly.Additional information was received on 06-jul-2021 from the patient.Route added.Text amended accordingly.Additional information was received on 06-jul-2021 from the patient.Formulation, strength and global ptc number added.Text amended accordingly.Additional information was received on 29-sep-2021 from the quality department.Ptc results added.Clinical course updated and text amended accordingly.Additional information was received on 06-jul-2021 from patient.Based on the information received the case was initially assessed as non-serious was upgraded to serious.Additional events of hypothyroid, poor circulation and its hard to walk and to ride bike and off label use of device were added with details.Clinical course was updated.Text amended accordingly.
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