FDA Adverse Event Injury Summary report: N

TOROSA SALINE-FILLED TESTICULAR PROSTHESIS

MDR report key: 20267205 · Received September 20, 2024

Report

Report Number
2125050-2024-01485
Event Type
Injury
Date Received
September 20, 2024
Date of Event
August 27, 2024
Report Date
October 9, 2024
Manufacturer
COLOPLAST A/S
Product Code
FAF
UDI-DI
05708932470858
PMA / PMN Number
P020003
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE LOT NUMBER WAS REVIEWED FOR COMPLAINT TREND, NONCONFORMING REPORT AND CAPA. DEVICES MET SPECIFICATION PRIOR TO RELEASE. NO TRENDS WERE NOTED FOR COMPLAINTS AND THERE WERE NO NONCONFORMING REPORTS OR CAPAS THAT WERE CONFIRMED IN VEEVA TO BE ASSOCIATED.

Additional Manufacturer Narrative · 0

CORRECTION: BASED ON THE ADDITIONAL INFORMATION THAT THERE WAS NO DEVICE MALFUNCTION, AND THE ADDITIONAL SURGICAL INTERVENTION WAS DUE TO PATIENT PREFERENCE ONLY- ANNEX A010103 AND F1905 WERE REMOVED.

Description of Event or Problem · 0

ACCORDING TO THE AVAILABLE INFORMATION, THE IMPLANT WAS REMOVED AND REPLACED DUE TO PATIENT PREFERENCE AND IMPLANT SIZE.

Description of Event or Problem · 0

ACCORDING TO ADDITIONAL INFORMATION, THE ORIGINAL IMPLANT WAS FILLED TO THE PHYSICIAN'S SPECIFICATIONS. THE REVISION WAS PROMPTED BY THE PATIENT WHO WANTED TO MAXIMIZE THE FILL VOLUME ONLY [PATIENT PREFERENCE]. THERE WAS NO REPORTED ISSUE WITH THE IMPLANT AND THE NEW IMPLANT FITTED WAS THE SAME SIZE WITH MAXIMUM FILL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1482918 TOROSA SALINE-FILLED TESTICULAR PROSTHESIS PROSTHESIS, TESTICULAR FAF COLOPLAST A/S 9391647_5206502400 05708932470858

Patients

Seq Age Sex Outcome Treatment
1 73 YR Male Required Intervention