FDA Adverse Event Injury Summary report: N

ELEVATE POSTERIOR PROLAPSE REPAIR SYSTEM

MDR report key: 2212563 · Received August 11, 2011

Report

Report Number
2183959-2011-00293
Event Type
Injury
Date Received
August 11, 2011
Date of Event
July 13, 2011
Report Date
July 13, 2011
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
FTL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
PHYSICIAN

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

AN ELEVATE POSTERIOR DEVICE WAS IMPLANTED. IT WAS REPORTED THAT THE PATIENT HAD "EROSION" OF THE DEVICE. ADDITIONAL INFORMATION RECEIVED INDICATES THAT ON (B)(6) 2011, THE PATIENT HAD "SIGMOIDOSCOPY MESH EXCISION AND DIVISION OF THE ELEVATE POSTERIOR MESH COMPRESSING RECTUM."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ELEVATE POSTERIOR PROLAPSE REPAIR SYSTEM SURGICAL MESH FTL AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention