BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INFLATABLE PENILE PROSTHESIS

    MDR report key: 117809 · Received September 4, 1997

    Report

    Report Number
    2126328-1997-03988
    Event Type
    Injury
    Date Received
    September 4, 1997
    Date of Event
    July 29, 1997
    Report Date
    September 4, 1997
    Manufacturer
    AMERICAN MEDICAL SYSTEMS, INC.
    Product Code
    FHW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    THE ENTIRE DEVICE WAS REMOVED FROM THE PATIENT AND REPLACED DUE TO FLUID LOSS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INFLATABLE PENILE PROSTHESIS Implant IPP FHW AMERICAN MEDICAL SYSTEMS, INC. 700 8164K 002,8164K 002,(MORE)

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Hospitalization| R