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