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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DAVOL INC., SUB. C.R. BARD, INC. -1213643 3DMAX MID; SURGICAL MESH

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DAVOL INC., SUB. C.R. BARD, INC. -1213643 3DMAX MID; SURGICAL MESH Back to Search Results
Catalog Number 0116311
Medical Device Problem Code Material Split, Cut or Torn (4008)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/19/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
As reported, the 3dmax mid mesh was found to be torn upon opening.Review of the returned sample is currently ongoing, as such no conclusions have been made.When the sample evaluation is completed, a supplemental mdr will be submitted.A review of the manufacturing records was performed and found that the lot was manufactured to specification.To date this is the only reported complaint for this lot of (b)(4) units released for distribution.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 the procedure, the 3dmax mid mesh was found to be torn upon opening the package.Reportedly, the outer packaging was intact with no signs of damage.The procedure was completed using another mesh without any complications.There was no patient injury.
 
Additional Manufacturer Narrative
As reported, the 3dmax mid mesh was found to be torn upon opening.Review of the returned sample is currently ongoing, as such no conclusions have been made.When the sample evaluation is completed, a supplemental mdr will be submitted.A review of the manufacturing records was performed and found that the lot was manufactured to specification.To date this is the only reported complaint for this lot of (b)(4) units released for distribution.Addendum: this is an addendum to the initial mdr submitted.This supplemental mdr is submitted to document the sample evaluation results.The sample evaluation confirms there is crack/tear in the edge seal of the 3dmax mid mesh.The tear starts in the seal edge and continues into the mesh.Based on returned sample evaluation performed, the reported condition is confirmed as manufacturing related.Awareness notification was provided to all appropriate manufacturing personnel on event reported, to emphasize the importance of product handling and inspection during manufacturing process.Updated fields: b4, g3, g6, h2, h3, h4, h6, h10.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 the procedure, the 3dmax mid mesh was found to be torn upon opening the package.Reportedly, the outer packaging was intact with no signs of damage.The procedure was completed using another mesh without any complications.There was no patient injury.
 
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Brand Name
3DMAX MID
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 Key22468129
Report Number1213643-2025-00606
Device Sequence Number19901763
Product Code FTL
UDI-Device Identifier00801741200755
UDI-Public(01)00801741200755(17)290228(10)HUJQ0680
Combination Product (Y/N)N
Initial Reporter StateGA
Initial Reporter CountryUS
PMA/510(K) Number
K200818
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,User Facility
Initial Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date (Section B) 07/11/2025
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 Catalogue Number0116311
Device Lot NumberHUJQ0680
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/20/2025
Supplement Date Received by Manufacturer07/22/2025
Initial Report FDA Received Date07/10/2025
Supplement Report FDA Received Date07/25/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/08/2024
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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