FDA Adverse Event Injury Summary report: N

GYNECARE GYNEMESH* PS

MDR report key: 2830556 · Received November 13, 2012

Report

Report Number
2210968-2012-07250
Event Type
Injury
Date Received
November 13, 2012
Report Date
October 25, 2012
Manufacturer
ETHICON, INC.
Product Code
FTL
PMA / PMN Number
K013718
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

(B)(4). CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY. THIS IS ONE OF TWO MEDWATCHES BEING SUBMITTED. SEE ALSO MEDWATCH 2210968-2012-07249. THE SAME PATIENT IS REPRESENTED IN EACH MEDWATCH.

Additional Manufacturer Narrative · 1

(B)(4). ADDITIONAL NARRATIVE: IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE AND MESH WAS IMPLANTED ON (B)(6) 2005 IN ORDER TO TREAT SYMPTOMATIC CYSTOCELE WITH MILD PELVIC RELAXATION. IT WAS REPORTED THAT FOLLOWING INSERTION THE PATIENT EXPERIENCED PAIN, URINARY PROBLEMS, RECURRENCE, AND BULGE IN VAGINA. IT WAS REPORTED THAT THE PATIENT UNDERWENT A ROBOTIC ASSISTED LAPAROSCOPIC SACROCOLPOPEXY, CYSTOTOMY REPAIR, CYSTOSCOPY, AND IMPLANTATION OF AMS INTERPRO MESH ON (B)(6) 2010. NO ADDITIONAL INFORMATION WAS PROVIDED. (B)(4) ¿ URINARY PROBLEMS; UNDEFINED RECURRENCE; PROLAPSE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE ON (B)(6) 2005 AND MESH WAS USED. THE PATIENT EXPERIENCED MESH EROSION, PAIN, INFECTION, DYSPAREUNIA AND OTHER INJURIES FOLLOWING THE PROCEDURE, AND SHE HAS UNDERGONE ADDITIONAL SURGERIES AND REVISIONARY PROCEDURES. NO ADDITIONAL INFORMATION IS PROVIDED AT THIS TIME

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GYNECARE GYNEMESH* PS MESH, SURGICAL, POLYMERIC FTL ETHICON, INC. NA NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention