MAUDE Adverse Event Report: ETHICON INC. PHYSIOMESH 20X25V; ABDOMINAL HERNIA SURGICAL MESH, COMPOSITE-POLYMER

Catalog Number PHY2025V

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problems Diarrhea (1811); Inflammation (1932); Nausea (1970); Pain (1994); Chills (2191); Weight Changes (2607); Decreased Appetite (4569)

Event Type  Injury  

Event Description

It was reported by an attorney that the patient underwent hernia repair surgery on (b)(6) 2011 and mesh was implanted.It was reported that the patient underwent recurrent hernia repair surgery on (b)(6) 2012 and mesh was implanted during which the surgeon noted a defect was noted in the inferior/lateral aspect where the mesh was not adhered to the abdominal wall.It was reported that the patient underwent revision surgery on (b)(6) 2012 during which the surgeon noted the mesh was palpated inferiorly and seemed to have pulled away in this area.It was reported that the patient underwent removal surgery and recurrent hernia repair surgery on (b)(6) 2013 and mesh was implanted during which the surgeon noted we did encounter a couple different layers of mesh in this area.It was inferiorly again where this appeared to have pulled free.Anteriorly, the mesh was identified as a thickened very fibrotic mass.Eventually during the procedure, we ended up removing pretty much all of this in its entirety.It was reported that the patient underwent removal surgery on (b)(6) 2016 during which the surgeon noted the mesh was identified in the lower abdomen and there was bowel adherent to the mesh and the pro-tak coils.A lysis of adhesions was done circumferentially to free the bowel from the mesh.The mesh and all foreign material was removed from the abdomen.It was reported that the patient underwent removal surgery on (b)(6) 2018.It was reported that the patient experienced severe pain, nausea, diarrhea, chills, inflammation, loss of appetite and extreme weight loss.It was reported that the patient had hernia repair surgery on (b)(6) 2011 and mesh was implanted.Other procedure is captured under separate file.No additional information was provided.

Manufacturer Narrative

To date, the device has not been returned.If the product is returned for evaluation, any further information derived from the evaluation will be submitted in a supplemental 3500a form.Mwr-22032022-0001152146 submitted for adverse event which occurred on (b)(6) 2012.Mwr-22032022-0001152145 submitted for adverse event which occurred on (b)(6) 2012.Mwr-22032022-0001152144 submitted for adverse event which occurred on (b)(6) 2013.Mwr-22032022-0001152143 submitted for adverse event which occurred on (b)(6) 2016.Mwr-22032022-0001152142 submitted for adverse event which occurred on (b)(6) 2018.

Manufacturer Narrative

Date sent to the fda: 3/30/2022.A review of the batch manufacturing records was conducted and the batch met all finished goods release criteria.

• Brand Name: PHYSIOMESH 20X25V
• Type of Device: ABDOMINAL HERNIA SURGICAL MESH, COMPOSITE-POLYMER
• Manufacturer (Section D): ETHICON INC.; 1000 route 202; raritan NJ 08869
• Manufacturer (Section G): ETHICON INC.-GMBH; p.o. box 1409; norderstedt D2284 1; GM D22841
• Manufacturer Contact: elba bello ; 1000 route 202; raritan, NJ 08869
• MDR Report Key: 13866438
• MDR Text Key: 288909667
• Report Number: 2210968-2022-02083
• Device Sequence Number: 1
• Product Code: FTL
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other
• Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date: 03/22/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/23/2022
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Expiration Date: 06/30/2013
• Device Catalogue Number: PHY2025V
• Device Lot Number: DH8CJTA0
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Date Manufacturer Received: 03/30/2022
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 07/06/2011
• 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
• Patient Outcome(s): Required Intervention
• Patient Sex: Female