FDA Adverse Event
Injury
Summary report: N
GYNECARE TVT OBTURATOR
MDR report key: 12212677
·
Received July 22, 2021
Report
- Report Number
- 2210968-2021-06602
- Event Type
- Injury
- Date Received
- July 22, 2021
- Date of Event
- August 31, 2015
- Report Date
- June 23, 2021
- Manufacturer
- ETHICON INC.
- Product Code
- OTN
- UDI-DI
- 10705031000346
- PMA / PMN Number
- K033568
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
PRODUCT COMPLAINT # (B)(4). A REVIEW OF THE BATCH MANUFACTURING RECORDS WAS CONDUCTED AND THE BATCH MET ALL FINISHED GOODS RELEASE CRITERIA FOR LOT 3489759 AND PRODUCT CODE 810081. NO ADDITIONAL INFORMATION IS AVAILABLE. IF FURTHER DETAILS ARE RECEIVED AT A LATER DATE A SUPPLEMENTAL MEDWATCH WILL BE SENT.
Description of Event or Problem · 1
IT WAS REPORTED THAT A PATIENT UNDERWENT A SLING PROCEDURE ON (B)(6) 2012 AND THE MESH WAS IMPLANTED. IT WAS REPORTED THAT THE PATIENT EXPERIENCED PAINFUL INTERCOURSE, PAIN IN THE GROIN, URINARY TRACT INFECTIONS, AND CONSTIPATION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1109700 | GYNECARE TVT OBTURATOR | MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC | OTN | ETHICON INC. | 810081 | 3489759 | 10705031000346 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |