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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ATRIUM MEDICAL C-QUR V-PATCH MESH, SURGICAL, POLYMERIC

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ATRIUM MEDICAL C-QUR V-PATCH MESH, SURGICAL, POLYMERIC Back to Search Results
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Anemia (1706); Anemia (1706); Dehydration (1807); Dehydration (1807); Dysphagia/ Odynophagia (1815); Edema (1820); Edema (1820); Hearing Loss (1882); High Blood Pressure/ Hypertension (1908); High Blood Pressure/ Hypertension (1908); Low Blood Pressure/ Hypotension (1914); Low Blood Pressure/ Hypotension (1914); Hypoxia (1918); Hypoxia (1918); Unspecified Infection (1930); Unspecified Infection (1930); Inflammation (1932); Inflammation (1932); Nausea (1970); Nausea (1970); Nerve Damage (1979); Nerve Damage (1979); Scarring (2061); Scarring (2061); Sepsis (2067); Sepsis (2067); Septic Shock (2068); Septic Shock (2068); Seroma (2069); Seroma (2069); Vomiting (2144); Vomiting (2144); Hernia (2240); Hernia (2240); Impaired Healing (2378); Impaired Healing (2378); Respiratory Failure (2484); No Code Available (3191)
Event Type  Injury  
Manufacturer Narrative
We are unable to fully investigate this event as no product code, lot number, or sample was provided. This report is based upon allegations made in a lawsuit in which atrium medical is named as a defendant. This report shall not be considered as an admission by atrium medical that the product described in the lawsuit claim and described herein is or was defective, or that it had any causal relationship to any injuries allegedly suffered by the plaintiff.
 
Event Description
This event is deemed reportable based on the allegations in a lawsuit which, while unsubstantiated, suggest that a reportable event may have occurred during use of atrium medical¿s mesh product. Plaintiff allegedly experienced infection, sepsis, sirs, septic shock, ileus, seroma formation, edema, improper wound healing, sequelae from infection, excessive and chronic inflammation, bowel obstruction, hypertension, hypotension, nerve damage, bilateral hearing loss, diarrhea, nausea, vomiting, dehydration, respiratory failure with hypoxia, oropharyngeal dysphagia, acute kidney injury, nerve damage, normocytic anemia, scarification, additional surgery and recurrence of hernia. Since this is a legal matter, the case has been turned over to legal counsel and further information obtained through investigation or discovery may fall under the attorney/client and/or work product privilege. However, atrium will supplement this report as appropriate if additional information comes to its attention.
 
Event Description
Plaintiff allegedly also experienced hemodynamic instability and a hematoma.
 
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Brand NameC-QUR V-PATCH
Type of DeviceMESH, SURGICAL, POLYMERIC
Manufacturer (Section D)
ATRIUM MEDICAL
40 continental blvd
merrimack NH 03054
Manufacturer (Section G)
ATRIUM MEDICAL
40 continental blvd
merrimack NH 03054
Manufacturer Contact
40 continental blvd
merrimack, NH 03054
MDR Report Key7652695
MDR Text Key112841542
Report Number3011175548-2018-00672
Device Sequence Number0
Product Code FTL
Combination Product (y/n)N
PMA/PMN Number
K080688
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type other
Reporter Occupation
Type of Report Initial,Followup
Report Date 06/29/2018
2 Devices were Involved in the Event: 1   2  
2 Patients were Involved in the Event: 1   2  
Date FDA Received06/29/2018
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received09/17/2018
Was Device Evaluated by Manufacturer? No Answer Provided
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

Patient Treatment Data
Date Received: 06/29/2018 Patient Sequence Number: 0
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