MAUDE Adverse Event Report: DAVOL INC., SUB. C.R. BARD, INC. -1213643 VENTRIO MESH; SURGICAL MESH

Catalog Number	0010213
Medical Device Problem Codes	Defective Device (2588); Patient-Device Incompatibility (2682); Insufficient Device Problem Information (3190)
Health Effect - Clinical Codes	Abdominal Pain (1685); Adhesion(s) (1695); Hernia (2240); Injury (2348); Obstruction/Occlusion (2422)
Date of Event	03/30/2020
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
No conclusions can be made.The patient's attorney alleges adverse patient outcome associated with the hernia mesh used to treat the patient.The patient's attorney alleges that the patient had subsequent surgical intervention; however, no details have been provided.No lot number has been provided; therefore, a review of the manufacturing records is not possible.This emdr represents the bard/davol ventrio mesh (device #1).An additional emdr was submitted to represent the bard/davol ventrio mesh (device #2).Should additional information be provided, a supplemental emdr will be submitted.Not returned.
Event or Problem Description
Attorney alleges that the patient underwent surgery for the implant of unspecified bard mesh (bard flat mesh) (x2) and bard/davol ventrio patch (x2).As reported, the patient is making a claim for an adverse patient outcome against ventrio patch (x2) which were implanted on (b)(6) 2020 and (b)(6) 2020.Attorney alleges that the patient had subsequent surgical intervention due to the hernia mesh device.It is also alleged that the patient experienced emotional distress and the device was defective.
Event or Problem Description
Attorney alleges that the patient underwent surgery for the implant of unspecified bard mesh (bard flat mesh) (x2) and bard/davol ventrio patch (x2).As reported, the patient is making a claim for an adverse patient outcome against ventrio patch (x2) which were implanted on (b)(6) 2020 and (b)(6) 2020.Attorney alleges that the patient had subsequent surgical intervention due to the hernia mesh device.It is also alleged that the patient experienced emotional distress and the device was defective.Addendum per additional information provided: (b)(6) 2020 ¿ patient was diagnosed with bilateral direct inguinal hernias thereby underwent laparoscopic repair with implant of two ventrio mesh (device 1 and 2).Per operative notes, ¿two inguinal hernias were noted.The left inguinal hernia was larger and ventrio mesh (device 1) was placed and in right side another ventrio mesh (device 2) was placed sutured and tacked.¿ (b)(6) 2020 - patient was diagnosed with recurrent bilateral direct inguinal hernia, abdominal pain and small bowel obstruction thereby underwent open repair with removal old previously placed mesh (device 1 and 2) and implant of bard pre-shaped mesh with keyhole (device 3 and 4).Per operative notes, ¿the bowel congested was reduced intra abdominally and adhesions were removed.In the left groin, the large incarcerated recurrent inguinal hernia with sac was noted and dissected.The previously placed bilateral mesh (device 1 and 2) were removed through left inguinal hernia sac.The sac was sutured and bard pre-shaped mesh with keyhole (device 3) was placed.In right groin, direct hernia sac was noted and reduced, another bard pre-shaped mesh with keyhole (device 4) was placed around the defect and sutured.¿.
Additional Manufacturer Narrative
No conclusions can be made.The patient's attorney alleges adverse patient outcome associated with the hernia mesh used to treat the patient.The patient's attorney alleges that the patient had subsequent surgical intervention; however, no details have been provided.No lot number has been provided; therefore, a review of the manufacturing records is not possible.This emdr represents the bard/davol ventrio mesh (device #1).An additional emdr was submitted to represent the bard/davol ventrio mesh (device #2).Should additional information be provided, a supplemental emdr will be submitted.Addendum: this supplemental emdr is submitted to document additional information provided.Root cause is inconclusive, no conclusion can be made as to the extent to which the implant may have caused or contributed to the patient's postoperative course.Note, the manufacturing date (15-jan-2019) is considered to be a best estimate.Updated fields: a2, b3, b4, b5, b7, d4 (product catalog no., corporate lot no., expiry date, udi no.), d6b (date of explant), g3, g6, h2, h4, h6, h10.This supplemental emdr represents the bard/davol - ventrio mesh (device 1).An additional supplemental emdr was submitted to represent the bard/davol - ventrio mesh (device 2).Note: 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: not returned.

• Brand Name: VENTRIO MESH
• Common Device Name: SURGICAL MESH
• Manufacturer (Section D): DAVOL INC., SUB. C.R. BARD, INC. -1213643; 100 crossings blvd.; warwick RI 02886
• Manufacturer (Section G): BARD SHANNON LIMITED 3005636544; san geronimo industrial park; lot #1, road #3, km 79.7; humacao PR 00791
• Manufacturer Contact: andrew topoulos ; 100 crossings blvd.; warwick, RI 02886 ; 4018258495
• MDR Report Key: 11017739
• Report Number: 1213643-2020-11200
• Device Sequence Number: 870391
• Product Code: FTL
• UDI-Device Identifier: 00801741016400
• UDI-Public: (01)00801741016400(17)220828(10)HUDN1236
• Combination Product (Y/N): N
• Initial Reporter State: MO
• Initial Reporter Country: US
• PMA/510(K) Number: K100229
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2020
• Device Explanted Year: 2020
• Reporter Type: Manufacturer
• Report Source: Other,Consumer
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 09/12/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Health Professional
• Device Expiration Date: 08/28/2022
• Device Catalogue Number: 0010213
• Device Lot Number: HUDN1236
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 12/14/2020
• Supplement Date Received by Manufacturer: 08/22/2025
• Initial Report FDA Received Date: 12/16/2020
• Supplement Report FDA Received Date: 09/12/2025
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 01/15/2019
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 74 YR
• Patient Sex: Female