FDA Adverse Event Malfunction Summary report: N

TVT EXACT RETROPUBIC SYSTEM

MDR report key: 23457756 · Received November 3, 2025

Report

Report Number
3003990090-2025-01705
Event Type
Malfunction
Date Received
November 3, 2025
Date of Event
October 15, 2025
Report Date
March 24, 2026
Manufacturer
CALDERA MEDICAL INC.
Product Code
OTN
PMA / PMN Number
K132054
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CORRECTION: G1. ADDTIONAL INFORMATION H6, H11. THE NEUCHÂTEL TEAM RECEIVED THREE PHOTOS FOR EVALUATION OF THE TVT EXACT PRODUCT, PRODUCT CODE TVTRL AND BATCH NUMBER 3945027. AN INVESTIGATION WAS CONDUCTED ON THE PHOTOS RECEIVED AND ON THE BATCH FILE. THE DEVICES HAVE BEEN MANIPULATED AND OPENED. THE INFORMATION IS HANDWRITTEN ON THE PACKAGING BOXES. A LABEL IS AFFIXED TO THE BOX THAT DOES NOT ORIGINATE FROM THE MANUFACTURING PROCESS IN NEUCHÂTEL. NO WHITE PARTICLES ARE VISIBLE IN THE PHOTO RECEIVED, AS THE BLISTER PACKS ARE NOT VISIBLE. BASED ON THE EVALUATION OF THE COMPLAINT (THE WHITE DUST IS "COVERING" THE SLINGS) CANNOT BE CONFIRMED WITH THE PHOTOS RECEIVED. THE INTERNAL COMPLAINT NUMBER IS (B)(4).

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUBMITTED IN ACCORDANCE WITH THE REQUIREMENTS OF 21 CFR PART 803. THE INFORMATION CONTAINED HEREIN IS BASED ON DATA AVAILABLE TO CALDERA MEDICAL AT THE TIME OF SUBMISSION AND MAY NOT HAVE BEEN FULLY INVESTIGATED OR INDEPENDENTLY VERIFIED PRIOR TO THE REQUIRED REPORTING DEADLINE. SUBMISSION OF THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR CONCLUSION BY CALDERA MEDICAL THAT THE PRODUCT CAUSED OR CONTRIBUTED TO THE REPORTED EVENT. THE INVESTIGATION REMAINS ONGOING. IN ACCORDANCE WITH MANUFACTURING PROCEDURES, TRAYS ARE INSPECTED AGAINST A BLACK BACKGROUND, AND NO PARTICLES WERE NOTED DURING THESE INSPECTIONS. A FINAL INSPECTION OF THE PRODUCT IS ALSO PERFORMED TO VERIFY PRODUCT INTEGRITY. ALL MESH DEVICES WERE STERILIZED USING ETHYLENE OXIDE, AND THE PRODUCTS WERE CONFIRMED TO MEET SPECIFICATIONS AT THE TIME OF RELEASE. A REVIEW OF THE MANUFACTURING RECORDS INDICATES THAT ALL PRODUCTS RELEASED DURING THE RELEVANT TIMEFRAME WERE MANUFACTURED IN ACCORDANCE WITH APPROVED PROCEDURES AND MET ALL ESTABLISHED SPECIFICATIONS DURING BOTH MANUFACTURING AND QUALITY RELEASE PROCESSES. AS THE PRODUCT WAS NOT RETURNED FOR EVALUATION, NO DEFINITIVE CONCLUSIONS CAN BE DRAWN REGARDING THE REPORTED EVENT AT THIS TIME. THE INVESTIGATION WILL CONTINUE, AND THIS REPORT WILL BE UPDATED SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE. THE MANUFACTURING NUMBER IS (B)(4).

Description of Event or Problem · 0

A SURGEON AT (B)(HAS RAISED CONCERNS ABOUT TVTRL, REPORTING THAT A WHITE DUST IS COVERING THE SLINGS. IN FACT, THEY DISCARDED ONE OF THE SLINGS IN THE TRASH. - DATE OF SURGERY: (B)(6) 2024 - PRODUCT LOT NUMBER(S): 3945027 - QUANTITY: (B)(4) UNITS - EXPIRATION DATE: MAY 31, 2026 - FACILITY NAME/LOCATION: (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
79256 TVT EXACT RETROPUBIC SYSTEM TVT-CAL-EXACT OTN CALDERA MEDICAL INC. TVTRL 3945027

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown