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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: JOHNSON & JOHNSON INTERNATIONAL PHYSIOMESH OVAL; MESH, SURGICAL, POLYMERIC

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JOHNSON & JOHNSON INTERNATIONAL PHYSIOMESH OVAL; MESH, SURGICAL, POLYMERIC Back to Search Results
Catalog Number PHY1015V
Device Problem Appropriate Term/Code Not Available (3191)
Patient Problems Cyst(s) (1800); Inflammation (1932); Pain (1994); Hernia (2240); Hematuria (2558); No Code Available (3191)
Event Type  Injury  
Manufacturer Narrative
(b)(4).To date the device has not been returned.If the device or further details are received at a later date a supplemental medwatch will be sent.
 
Event Description
It was reported by an attorney that the patient underwent a laparoscopic incisional hernia repair on (b)(6) 2012 and mesh was implanted.It was reported that the hernia returned within days of the surgery, and on (b)(6) 2012, the patient was admitted again to the hospital to repair a recurrent incisional hernia.The surgeon noted that he could easily visualize the superior aspect of the mesh that had been placed laparoscopically and the tail that had been intended to hang down well over the symphysis pubis as one would use a long shirttail pulled up into the wound.The surgeon trimmed this off and then actually secured this to the undersurface of the abdominal wall.The surgeon then, via an open repair surgery, implanted another mesh.On (b)(6) 2013, the patient experienced a rush of extreme pain.Her bowels had come loose through her muscular wall, and was rushed into surgery.The doctor at another facility performed the surgery.It was noted that the mesh had disintegrated into the intestines and bowels, and the surgeon was not able to remove all the mesh.The patient continues to experience hematuria and chronic interstitial cystitis.She cannot lift more than 10 to 12 pounds without pain and inflammation.No additional information was provided.
 
Manufacturer Narrative
In addition, a review of the batch manufacturing records was conducted and the batch met all finished goods release criteria.
 
Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.Based on the information received, the cause of the reported incident could not be conclusively determined.
 
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Brand Name
PHYSIOMESH OVAL
Type of Device
MESH, SURGICAL, POLYMERIC
Manufacturer (Section D)
JOHNSON & JOHNSON INTERNATIONAL
leonardo da vincilaan 15
diegem 1831
BE  1831
Manufacturer (Section G)
ETHICON INC.-GMBH
robert-koch strasse 1
norderstedt D-228 51
GM   D-22851
Manufacturer Contact
darlene kyle
route 22 west po box 151
somerville, NJ 08876
9082182792
MDR Report Key6561663
MDR Text Key74989994
Report Number2210968-2017-60220
Device Sequence Number1
Product Code FTL
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K093932
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other
Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date 04/03/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/11/2017
Is this an Adverse Event Report? Yes
Device Operator Health Professional
Device Expiration Date03/31/2014
Device Catalogue NumberPHY1015V
Device Lot NumberED8GGHAD
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received03/19/2018
Was Device Evaluated by Manufacturer? No
Date Device Manufactured04/01/2012
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age44 YR
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