FDA Adverse Event Injury Summary report: N

VIRTUE VENTRAL URETHRAL ELEVATION SLING SYSTEM

MDR report key: 1695122 · Received May 20, 2010

Report

Report Number
2125050-2010-00007
Event Type
Injury
Date Received
May 20, 2010
Date of Event
February 8, 2010
Report Date
April 22, 2010
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 DEVICE REMAINS IMPLANTED IN THE PATIENT, SO NO EVALUATION WAS PERFORMED. BECAUSE THE DEVICE REMAINS IMPLANTED AND BECAUSE COLOPLAST'S EXAMINATION MAY NOT CONCLUSIVELY CONFIRM OR DISPROVE THE REPORT OF PAIN, COLOPLAST ACCEPTS THE PHYSICIAN'S OBSERVATION OF PAIN AS THE REASON FOR THE MEDICAL INTERVENTION. DEVICE STILL IMPLANTED - NOT RETURNED.

Description of Event or Problem · 1

(B) (6). AS REPORTED TO COLOPLAST, A PATIENT EXPERIENCED MILD SCROTAL PAIN AT 3 MONTHS AFTER IMPLANT AND IS TREATED WITH PHYSICAL THERAPY. THE PAIN IS UNRESOLVED. THE DEVICE REMAINS IMPLANTED TO DATE.

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 5002011400 1908488

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention