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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MENTOR TEXAS MENTOR ARTOURA PLUS, SMOOTH, HIGH PROFILE; EXPANDER, SKIN, INFLATABLE

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MENTOR TEXAS MENTOR ARTOURA PLUS, SMOOTH, HIGH PROFILE; EXPANDER, SKIN, INFLATABLE Back to Search Results
Catalog Number SDC110H
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code Deformity/ Disfigurement (2360)
Date of Event 04/01/2024
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Since the device has not been returned for analysis, no product failure analysis can be conducted, and no determination of possible contributing factors can be made.As such, the investigation will be closed.If the complaint device is received in the future, the investigation will be reopened and conducted as appropriate.A manufacturing record evaluation (mre) was performed, and no anomalies were found related to this complaint.In addition, the mre verifies that the device was manufactured in accordance with documented specification and procedures.Reason for device explant and/or reoperation: right deflation.Mentor is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which mentor has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, mentor, or its employees that the report constitutes an admission that the device, mentor, or its employees caused or contributed to the potential event described in this report.Manufacturer¿s reference number: (b)(4).
 
Event or Problem Description
It was reported that a 49-year-old caucasian female patient underwent primary breast reconstruction surgery with 300cc mentor artoura plus, smooth, high profile and experienced expander deflation on her right side postoperatively; diagnosed after physical exam.The patient has consulted with the healthcare professional.Per the information provided, the patient has a history of right breast cancer, which led to the use of tissue expanders.The patient underwent bilateral replacement surgery with serial numbers (b)(6) on the left side, and with (b)(6) on the right side on (b)(6) 2024.
 
Additional Manufacturer Narrative
On october 30, 2024, the mentor failure analysis lab received the device for evaluation.On november 6, 2024, device evaluation was completed as follows: mentor conducted visual inspection, leak testing, and microscopic examination of the returned device.Visual analysis of the returned sample determined that a tear was found on the posterior aspect of the artoura plus sm te hp 300cc tissue expander, measuring approximately 0.6 cm.Additionally, the tissue expander was received painted in blue.Leak testing was performed, in accordance with mentor procedures, and no additional leak sites were detected during the analysis.Microscopic examination was performed on the edges of the rupture, and parallel striations were found in the whole area of the tear.Parallel striations are consistent with markings made by a sharp object perforating the tissue expander shell.Based on the information currently available, a microscopic examination of the returned product indicates that the tissue expander could have been damaged during or subsequent to implantation.The product insert data sheet cautions not to allow cautery devices or sharp instruments, such as scalpels, suture needles, hypodermic needles, hemostats, adson forceps or scissors to contact the device during the implantation or other surgical procedures.As part of mentor¿s quality process, all devices are manufactured, inspected, and released to approved specifications.No corrective and preventive action (capa) is required now.Additional complaint information monitoring for potential safety signals is conducted through complaint trending as part of post-market surveillance.Manufacturer¿s reference number: (b)(4).
 
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Brand Name
MENTOR ARTOURA PLUS, SMOOTH, HIGH PROFILE
Common Device Name
EXPANDER, SKIN, INFLATABLE
Manufacturer (Section D)
MENTOR TEXAS
3041 skyway circle north
irving TX 75038
Manufacturer (Section G)
MENTOR TEXAS
3041 skyway circle north
irving TX 75038
Manufacturer Contact
kate karberg
3041 skyway circle north
irving, TX 75038
3035526892
MDR Report Key20404284
Report Number1645337-2024-11502
Device Sequence Number3379257
Product Code LCJ
UDI-Device Identifier10081317028175
UDI-Public(01)10081317028175(17)270715(10)9934143
Combination Product (Y/N)N
Initial Reporter StateNJ
Initial Reporter CountryUS
PMA/510(K) Number
K161176
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Device Explanted Year2024
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other
Type of Report Initial,Followup
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? Yes
Operator of Device Health Professional
Device Catalogue NumberSDC110H
Device Lot Number9934143
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 09/23/2024
Supplement Date Received by Manufacturer10/30/2024
Initial Report FDA Received Date10/08/2024
Supplement Report FDA Received Date11/08/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/18/2023
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 Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age49 YR
Patient SexFemale
Patient EthnicityNon Hispanic
Patient RaceWhite
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