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U.S. Department of Health and Human Services

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

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DAVOL INC., SUB. C.R. BARD, INC. -1213643 VENTRIO MESH; SURGICAL MESH Back to Search Results
Catalog Number 0010212
Medical Device Problem Code Expiration Date Error (2528)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/19/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
As reported, an expired ventrio mesh was inadvertently implanted beyond its labeled expiration date.The expiration date is included on the labeling of this product and is located on multiple levels of the packaging.This event is confirmed as a use related error, with no malfunction of the device.Review of manufacturing records confirms product was manufactured to specification.To date, this is the only reported complaint for this manufacturing lot.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.
 
Event or Problem Description
As reported, during a procedure, a ventrio mesh which had a labeled expiration date of 28-oct-2024 was implanted in the patient on (b)(6)2024.There was no patient injury, change in course of treatment, or any medical/surgical intervention.
 
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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
8005566756
MDR Report Key20862939
Report Number1213643-2024-00574
Device Sequence Number8694352
Product Code FTL
UDI-Device Identifier00801741016394
UDI-Public(01)00801741016394(17)241028(10)HUFS0218
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
K100229
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Nurse
Type of Report Initial
Report Date (Section B) 11/22/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date10/28/2024
Device Catalogue Number0010212
Device Lot NumberHUFS0218
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/20/2024
Initial Report FDA Received Date12/06/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/27/2021
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 Other;
Patient SexUnknown
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