MAUDE Adverse Event Report: SOFRADIM PRODUCTION SAS PARIETEX; MESH, SURGICAL, POLYMERIC

Model Number TECR1510

Device Problems Migration or Expulsion of Device (1395); Adverse Event Without Identified Device or Use Problem (2993)

Patient Problems Adhesion(s) (1695); Nausea (1970); Nerve Damage (1979); Pain (1994); Hernia (2240); Injury (2348); No Code Available (3191)

Event Type  Injury  

Manufacturer Narrative

Concomitant medical products: tecr1510, parietex rigid py 15x10 cm x1 (lot# sga00442); protack 5 mm single use instrument (lot# p7c0841).(b)(4).If information is provided in the future, a supplemental report will be issued.

Event Description

The patient¿s attorney alleged a deficiency against the device.The product was used for laparoscopic therapeutic treatment of bilateral inguinal hernia and an umbilical hernia.It was reported that after implant, the patient experienced severe pain, nausea, recurrence, adhesions, mesh migration, lump in groin, upset stomach, pulling sensation, and nerve damage.Post-operative patient treatment included revision surgery and hernia repair with new mesh.

• Brand Name: PARIETEX
• Type of Device: MESH, SURGICAL, POLYMERIC
• Manufacturer (Section D): SOFRADIM PRODUCTION SAS; 116 avenue du formans; trevoux 01600 ; FR 01600
• Manufacturer (Section G): SOFRADIM PRODUCTION SAS; 116 avenue du formans; trevoux 01600 ; FR 01600
• Manufacturer Contact: lisa hernandez ; 60 middletown ave.; north haven, CT 06473 ; 2034925563
• MDR Report Key: 10614012
• MDR Text Key: 209406683
• Report Number: 9615742-2020-02254
• Device Sequence Number: 1
• Product Code: FTL
• UDI-Device Identifier: 10884521180284
• UDI-Public: 10884521180284
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K982532
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date: 10/01/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 10/01/2020
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 01/31/2011
• Device Model Number: TECR1510
• Device Catalogue Number: TECR1510
• Device Lot Number: SGA00442
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 09/09/2020
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Treatment: UNKNOWN MESH
• Patient Outcome(s): Required Intervention
• Patient Weight: 73