FDA Adverse Event Injury Summary report: N

GREENLIGHT MOXY FIBER OPTIC

MDR report key: 2831227 · Received November 6, 2012

Report

Report Number
2937094-2012-01187
Event Type
Injury
Date Received
November 6, 2012
Date of Event
May 23, 2012
Report Date
October 8, 2012
Manufacturer
AMERICAN MEDICAL SYSTEMS
Product Code
GEX
PMA / PMN Number
K092735
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4) USED FOR RETROGRADE EJACULATION.

Description of Event or Problem · 1

IT WAS REPORTED A CLINICAL STUDY PT HAD A BENIGN PROSTATIC HYPERPLASIA (BPH) PROCEDURE ON (B)(6) 2012. FOUR MONTHS, THREE WEEKS POST PROCEDURE, THE PT PRESENTED WITH RETROGRADE EJACULATION, ONSET DATE (B)(6) 2012; CONTINUING AS OF (B)(6) 2012. NO FURTHER INFORMATION WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GREENLIGHT MOXY FIBER OPTIC POWERED LASER SURGICAL INSTRUMENT GEX AMERICAN MEDICAL SYSTEMS 0010-2400 130A

Patients

Seq Age Sex Outcome Treatment
1 Other ACCESSORIES| GREENLIGHT XPS LASER SYSTEM