FDA Adverse Event
Injury
Summary report: N
MINIARC SINGLE-INCISION SLING
MDR report key: 2890724
·
Received December 21, 2012
Report
- Report Number
- 2183959-2012-03372
- Event Type
- Injury
- Date Received
- December 21, 2012
- Report Date
- October 22, 2012
- Manufacturer
- AMERICAN MEDICAL SYSTEMS, INC.
- Product Code
- FTL
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE REGARDING THIS EVENT IT WILL BE RE-EVALUATED AND A FOLLOW-UP REPORT WILL BE SENT AS APPROPRIATE. LAWYER-FILED REPORT-(B)(4).
Description of Event or Problem · 1
IT WAS REPORTED BY THE PLAINTIFF'S ATTORNEY THAT THE PLAINTIFF EXPERIENCED AN UNSPECIFIED INJURY AND A PROBLEM WITH THE PRODUCT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | MINIARC SINGLE-INCISION SLING | SURGICAL MESH | FTL | AMERICAN MEDICAL SYSTEMS, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Disability | ANTERIOR SYNTHETIC SUPPORT SYSTEM| POSTERIOR SYNTHETIC SUPPORT SYSTEM | POSTERIOR SYNTHETIC SUPPORT SYSTEM| ANTERIOR SYNTHETIC SUPPORT SYSTEM |