FDA Adverse Event Injury Summary report: N

ADVANTAGE SYSTEM

MDR report key: 2742574 · Received September 13, 2012

Report

Report Number
3005099803-2012-04143
Event Type
Injury
Date Received
September 13, 2012
Report Date
August 29, 2012
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K020110
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
RI, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED LOT NUMBER 850200 COULD NOT BE MATCHED TO THE REPORTED DEVICE. THEREFORE, THE LOT EXPIRATION AND DEVICE MANUFACTURE DATES ARE UNKNOWN AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN ADVANTAGE TRANSVAGINAL MID-URETHRAL SLING SYSTEM WAS IMPLANTED INTO THE PATIENT ON (B)(6) 2009. ACCORDING TO THE COMPLAINANT, THE PATIENT EXPERIENCED PAIN, DYSPAREUNIA AND ADDITIONAL PROCEDURE/SURGERY TO REMOVE THE RIGHT ARM OF THE SLING. ALL OTHER INFORMATION, INCLUDING THE PATIENT'S CURRENT CONDITION, IS UNKNOWN AND REPORTEDLY UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADVANTAGE SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH M0068502000

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention