FDA Adverse Event Injury Summary report: N

IVS TUNNELLER

MDR report key: 2922136 · Received January 11, 2013

Report

Report Number
6000141-2013-00006
Event Type
Injury
Date Received
January 11, 2013
Date of Event
April 29, 2003
Report Date
December 14, 2012
Manufacturer
BALLYMONEY - USS
Product Code
FTL
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PROCEDURE: UROGYNECOLOGICAL. ACCORDING TO THE REPORTER: THE PT ALLEGES INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
18126 IVS TUNNELLER IVS TUNNELLER FTL BALLYMONEY - USS 0211016-04

Patients

Seq Age Sex Outcome Treatment
1 52 YR