FDA Adverse Event
Injury
Summary report: N
AXONICS
MDR report key: 14342568
·
Received May 9, 2022
Report
- Report Number
- 3002968685-2022-00041
- Event Type
- Injury
- Date Received
- May 9, 2022
- Date of Event
- April 12, 2022
- Report Date
- May 9, 2022
- Manufacturer
- AXONICS MODULATION TECHNOLOGIES, INC.
- Product Code
- EZW
- UDI-DI
- 10810005340066
- PMA / PMN Number
- P180046
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 0
THE COMPANY WAS MADE AWARE THAT A PATIENT UNDERWENT AN EXPLANT SURGERY DUE TO AN ALLERGIC REACTION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1442612 | AXONICS | NEUROSTIMULATOR | EZW | AXONICS MODULATION TECHNOLOGIES, INC. | 1101 | 10810005340066 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |