FDA Adverse Event Injury Summary report: N

OBTRYX SYSTEM

MDR report key: 2912424 · Received January 12, 2013

Report

Report Number
3005099803-2013-00184
Event Type
Injury
Date Received
January 12, 2013
Report Date
December 17, 2012
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K040787
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED LOT NUMBER 0ML6051909 COULD NOT BE MATCHED TO THE REPORTED DEVICE. THEREFORE, THE LOT EXPIRATION AND DEVICE MANUFACTURE DATES ARE UNKNOWN AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN OBTRYX TRANSOBTURATOR MID-URETHRAL SLING SYSTEM WAS IMPLANTED INTO THE PATIENT ON (B)(6) 2006. ACCORDING TO THE COMPLAINANT, THE PATIENT EXPERIENCED VAGINAL EROSION, RECURRENT URINARY TRACT/BLADDER INFECTIONS, MESH EROSION, BLADDER PERFORATIONS, INCONTINENCE, AND ABDOMINAL AND PELVIC PAIN. ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION REGARDING THE CIRCUMSTANCES SURROUNDING THIS EVENT HAVE BEEN UNSUCCESSFUL TO DATE. SHOULD ADDITIONAL RELEVANT DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
19350 OBTRYX SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH M0068504000

Patients

Seq Age Sex Outcome Treatment
1 Other