FDA Adverse Event Injury Summary report: N

VIRTUE VENTRAL URETHRAL ELEVATION SLING SYSTEM

MDR report key: 1571546 · Received January 7, 2010

Report

Report Number
2125050-2010-00001
Event Type
Injury
Date Received
January 7, 2010
Date of Event
November 11, 2009
Report Date
December 11, 2009
Manufacturer
COLOPLAST MANUFACTURING US, LLC
Product Code
FTL
PMA / PMN Number
K082640
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INITIALLY-IMPLANTED DEVICE WAS NOT RETURNED, SO NO EVALUATION WAS PERFORMED. THE DEVICE USED FOR REVISION REMAINS IMPLANTED IN THE PATIENT. DEVICE NOT RETURNED.

Description of Event or Problem · 1

AS REPORTED TO COLOPLAST, A PATIENT WENT IN FOR A PLANNED REVISION OF THE INITIAL SLING. DURING SLING REVISION, WHEN APPLYING TENSION TO THE RIGHT PREPUBIC ARM, IT SNAPPED. THE TECHNIQUE USED TO IMPLANT THE NEW SLING WAS DIFFERENT FROM THE PROTOCOL-DIRECTED TECHNIQUE. THE SLING WAS THEN FULLY EXPLANTED, AND A NEW VIRTUE SLING WAS PLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VIRTUE VENTRAL URETHRAL ELEVATION SLING SYSTEM SURGICAL MESH FTL COLOPLAST MANUFACTURING US, LLC 5002001400

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention