FDA Adverse Event Injury Summary report: N

OBTRYX SYSTEM

MDR report key: 2854888 · Received December 3, 2012

Report

Report Number
3005099803-2012-05712
Event Type
Injury
Date Received
December 3, 2012
Report Date
November 14, 2012
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K040787
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
ATTORNEY

Narratives

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT THE PATIENT WAS IMPLANTED WITH AN OBTRYX TRANSOBTURATOR MID-URETHRAL SLING SYSTEM DURING A PROCEDURE ON (B)(6) 2006. ACCORDING TO THE COMPLAINANT, POST-PROCEDURE, THE PATIENT EXPERIENCED EXTREME PAIN, BLADDER SPASMS, CONTINUED URINARY INCONTINENCE, EROSION OF HER INTERNAL BODILY TISSUE (SPECIFICS UNKNOWN). ALL OTHER INFORMATION IS UNKNOWN AND UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OBTRYX SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH UNK676

Patients

Seq Age Sex Outcome Treatment
1 Other