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U.S. Department of Health and Human Services

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

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DAVOL INC., SUB. C.R. BARD, INC. VENTRALEX; SURGICAL MESH Back to Search Results
Catalog Number UNKAA077
Device Problems Defective Device (2588); Insufficient Information (3190)
Patient Problems Fistula (1862); Neuropathy (1983); Hernia (2240)
Event Date 06/15/2017
Event Type  Injury  
Manufacturer Narrative
At this time no conclusions can be made to what extent the bard/davol ventralex (device #1) may have caused or contributed to the reported event.The cause of the patient postoperative complications cannot be determined at this time.Recurrence and fistulas is a known inherent risk of surgery and is listed in the instructions-for-use a possible complication.Information is limited at this time.Should additional information be provided a supplemental emdr will be submitted.This emdr represents the bard/davol ventralex (device #1).The patient's attorney did not make any allegations regarding the implanted bard/davol phasix.Note: not returned.
 
Event Description
The following was alleged by the patient's attorney: (b)(6) 2016: the patient was implanted with a bard/davol ventralex mesh(device #1) for the repair of an umbilical hernia.Ni/ni/ 2017: the patient underwent removal surgery and upon entering the abdominal cavity, the patient's surgeon noted that the bard/davol ventralex mesh had failed and removed the mesh.At the same time as the ventralex mesh(device #1) was removed, the surgeon implanted a bard/davol phasix mesh in an attempt to repair the recurring umbilical hernia that was aggravated and caused by the initial mesh repair surgery.The patient is experiencing abdominal pain, bloating, and is limited in her mobility due to her injuries from the bard/davol ventralex mesh (device #1).The patient has suffered pain, neuropathy, fistula, scarring and intestinal blockage and will continue to suffer physical pain and mental anguish from her hernia mesh surgery.As a result of having the bard/davol ventralex mesh (device #1) implanted, the patient has experienced significant mental and physical pain and suffering and mental anguish, has sustained permanent injury, has undergone medical treatment and will likely undergo further medical treatment and procedures due to the alleged defective ventralex mesh (device #1).
 
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Brand Name
VENTRALEX
Type of Device
SURGICAL MESH
Manufacturer (Section D)
DAVOL INC., SUB. C.R. BARD, INC.
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
jan ling
100 crossings blvd.
warwick, RI 02886
8015652663
MDR Report Key8180208
MDR Text Key130879843
Report Number1213643-2018-04869
Device Sequence Number1
Product Code FTL
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K132441
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type consumer,other
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 12/19/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/19/2018
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberUNKAA077
Was Device Available for Evaluation? No
Date Manufacturer Received12/11/2018
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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; Disability;
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