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

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.

• Brand Name: GENTRIX SURGICAL MATRIX THICK
• Type of Device: GENTRIX 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 Key: 9500492
• MDR Text Key: 191919809
• Report Number: 3005920706-2019-00022
• Device Sequence Number: 1
• Product Code: FTM
• UDI-Device Identifier: 00386190001561
• UDI-Public: (01)00386190001561(17)210430(10)016398
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K170763
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,health
• Reporter Occupation: Physician
• 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 Received: 12/20/2019
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 04/30/2021
• Device Model Number: PSMT2030
• Device Catalogue Number: PSMT2030
• Device Lot Number: 016398
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Date Manufacturer Received: 11/21/2019
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 04/20/2019
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Other