FDA Adverse Event Injury Summary report: N

MINIARC

MDR report key: 2123195 · Received June 10, 2011

Report

Report Number
2183959-2011-00188
Event Type
Injury
Date Received
June 10, 2011
Date of Event
May 18, 2011
Report Date
May 18, 2011
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
FTL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE REGARDING THIS EVENT, IT WILL BE RE-EVALUATED AND A FOLLOW-UP REPORT WILL BE SENT.

Description of Event or Problem · 1

REPORTEDLY SOMETIME IN (B)(6) 2011, THIS PATIENT HAD A MINIARC SLING IMPLANTED. APPROXIMATELY 4 MONTHS LATER, THE PATIENT "STARTED TO FEEL PINCHING INSIDE". DURING AN EXAMINATION BY A PHYSICIAN, THE PATIENT WAS FOUND TO HAVE MESH PROTRUDING THROUGH HER VAGINAL WALL, BELIEVED TO BE THE CAUSE OF HER PAIN. THE PATIENT HAD AN OUT-PATIENT PROCEDURE TO REVISE THE MESH SLING. DETAILS OF THE PATIENT OUTCOME AND PROCEDURE WERE NOT PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MINIARC SINGLE-INCISION SLING FTL AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention| S