FDA Adverse Event
Malfunction
Summary report: N
UNK
MDR report key: 1564937
·
Received November 18, 2009
Report
- Report Number
- 2183959-2009-00144
- Event Type
- Malfunction
- Date Received
- November 18, 2009
- Date of Event
- November 18, 2009
- Report Date
- December 17, 2009
- Manufacturer
- AMERICAN MEDICAL SYSTEMS, INC.
- Product Code
- FTL
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MI, US
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
INFO WE REC'D ON 11/18/2009 THAT INDICATES AN UNK MALE SLING WAS TAKEN OUT (REMOVED) A YEAR AGO; BECAUSE IT WASN'T WORKING. NO FURTHER INFO WAS PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | UNK | SURGICAL MESH | FTL | AMERICAN MEDICAL SYSTEMS, INC. | NA | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 68 YR | Hospitalization| R |