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