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

Catalog Number 0010213

Device Problems Defective Device (2588); Detachment of Device or Device Component (2907); Insufficient Information (3190)

Patient Problems Adhesion(s) (1695); Hernia (2240); Disability (2371)

Event Date 06/20/2012

Event Type  Injury  

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 including permanent injury, adhesions, inflammation and recurrence. The instructions-for-use supplied with the device lists adhesions, inflammation and recurrence as possible complications. A review of the manufacturing records was performed for the subject lot and found that the lot was manufactured to specification. Should additional information be provided, a supplemental emdr will be submitted. Not returned.

Event Description

Attorney alleges that on or about (b)(6) 2011, the patient underwent a surgery for the repair of left lower abdominal hernia with implant of a non-bard/davol mesh and a bard/davol ventrio mesh. On or about (b)(6) 2012, the patient underwent revision surgery of both mesh products. Attorney alleges that the patient experienced and/or continues to experience severe and chronic pain, inflammation, swelling in the lymphatic nodules in the lower abdomen, adhesions, recurrence, and mesh detachment as a result of their implantation with the mesh products. Attorney also alleges general allegations for "past, present, and future damages, including but not limited to, mental and physical pain and suffering for severe and permanent personal injuries sustained by the patient". It is also alleged that the device was defective.

• Brand Name: VENTRIO MESH
• Type of Device: SURGICAL MESH
• Manufacturer (Section D): DAVOL INC., SUB. C.R. BARD, INC.; 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: 11380678
• MDR Text Key: 233721339
• Report Number: 1213643-2021-01312
• Device Sequence Number: 1
• Product Code: FTL
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K100229
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer,other
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date: 02/25/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 02/25/2021
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No

Device Operator

• Device Expiration Date: 12/28/2011
• Device Catalogue Number: 0010213
• Device Lot Number: HUUF2014
• Was Device Available for Evaluation?: No

Is the Reporter a Health Professional?

Was the Report Sent to FDA?

• Event Location: No Information
• Date Manufacturer Received: 02/04/2021
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 07/28/2010
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial

Patient Treatment Data

Date Received: 02/25/2021 Patient Sequence Number: 1