FDA Adverse Event Injury Summary report: N

ADVANTAGE SYSTEM

MDR report key: 2191454 · Received August 4, 2011

Report

Report Number
3005099803-2011-02714
Event Type
Injury
Date Received
August 4, 2011
Report Date
July 12, 2011
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K020110
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WV, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN ADVANTAGE TRANSVAGINAL SLING SYSTEM WAS USED DURING A PROCEDURE ON (B)(6) 2010. ACCORDING TO THE COMPLAINANT, THE PATIENT EXPERIENCED EROSION, CHRONIC INFECTION, AND DYSPAREUNIA. THE DATE OF ONSET AND DURATION FOR EACH IS UNKNOWN. THE PATIENT'S CURRENT CONDITION IS UNKNOWN. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION REGARDING THIS EVENT HAVE BEEN UNSUCCESSFUL TO DATE. SHOULD ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADVANTAGE SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH UNK13

Patients

Seq Age Sex Outcome Treatment
1 Other