FDA Adverse Event Injury Summary report: N

MALE REEMEX SYSTEM

MDR report key: 1410356 · Received July 7, 2009

Report

Report Number
3006621295-2009-00001
Event Type
Injury
Date Received
July 7, 2009
Date of Event
June 12, 2009
Report Date
June 29, 2009
Manufacturer
DIMA S.L.
Product Code
FTL
PMA / PMN Number
K062341
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SENT LETTER TO PATIENT TO ASK FOR THE DEVICE TO BE ANALYZED AT MANUFACTURING FACILITY.

Description of Event or Problem · 1

THE PATIENT SENT A LETTER ANNOUNCING HE HAD AN IMPORTANT INFECTION AND URINARY RETENTION AFTER IMPLANT OF TWO MALE REMEEX SYSTEMS. ACTUAL SITUATION IS THAT HE IS NOW INCONTINENT AFTER SYSTEM EXPLANTATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MALE REEMEX SYSTEM FTL DIMA S.L. MRS NA

Patients

Seq Age Sex Outcome Treatment
1 70 YR Hospitalization| R