FDA Adverse Event Injury Summary report: N

ELEVATE APICAL AND POSTERIOR

MDR report key: 2880831 · Received December 13, 2012

Report

Report Number
2183959-2012-03248
Event Type
Injury
Date Received
December 13, 2012
Report Date
October 31, 2012
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
FTL
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SHOULD ADD¿L INFO BECOME AVAILABLE REGARDING THIS EVENT IT WILL BE RE-EVALUATED AND A FOLLOW-UP REPORT WILL BE SENT. LAWYER-FILED REPORT - (B)(4).

Description of Event or Problem · 1

RELATED TO MFR #: 2183959-2012-03246 AND 2183959-2012-03247. IT WAS REPORTED BY THE PLAINTIFF'S ATTORNEY THAT THE PLAINTIFF EXPERIENCED EMOTIONAL DISTRESS AND A PROBLEM WITH THE PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ELEVATE APICAL AND POSTERIOR SURGICAL MESH FTL AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Disability ELEVATE APICAL AND ANTERIOR| MINIARC PRECISE| MINIARC PRECISE| ELEVATE APICAL AND ANTERIOR