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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ACELL, INC. GENTRIX SURGICAL MATRIX THICK

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ACELL, INC. GENTRIX SURGICAL MATRIX THICK Back to Search Results
Model Number PSMT2030
Device Problem Material Split, Cut or Torn (4008)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
Event Date 11/21/2019
Event Type  malfunction  
Manufacturer Narrative
This mdr is being submitted due to the reported suture pull through that occurred during the initial placement of the acell device. The device was not used and was discarded. Surgeon choose to use an unknown, non-acell device. The patient did not experience any complication due to the suture pull through. The device was not returned to acell for further investigation. A review of the manufacturing records for this lot identified no deviations in the production process that fall outside of specification. The device was manufactured and distributed sterile in compliance with acell's operating procedures and federal, state, and local laws and regulations.
 
Event Description
On"11/2119," acell, inc. Became aware that suture pull through occurred with an acell device during an incisional hernia repair. The device was not used. The surgeon decided to use an unknown, non-acell device which resulted in a surgical delay (increased surgery time). The patient did not experience any complication due to the suture pull through nor the increased surgery time.
 
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Brand NameGENTRIX SURGICAL MATRIX THICK
Type of DeviceGENTRIX SURGICAL MATRIX THICK
Manufacturer (Section D)
ACELL, INC.
6640 eli whitney dr.
columbia MD 21046
Manufacturer (Section G)
ACELL, INC.
6640 eli whitney dr.
columbia MD 21046
Manufacturer Contact
barry brainard
6640 eli whitney dr.
columbia, MD 21046
4109538558
MDR Report Key9500492
MDR Text Key191919809
Report Number3005920706-2019-00022
Device Sequence Number1
Product Code FTM
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K170763
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation
Type of Report Initial
Report Date 12/03/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/20/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator
Device Expiration Date04/30/2021
Device Model NumberPSMT2030
Device Catalogue NumberPSMT2030
Device Lot Number016398
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received11/21/2019
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured04/20/2019
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

Patient Treatment Data
Date Received: 12/20/2019 Patient Sequence Number: 1
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