FDA Adverse Event Injury Summary report: N

SPARC SLING SYSTEM

MDR report key: 2922297 · Received January 11, 2013

Report

Report Number
2183959-2013-00206
Event Type
Injury
Date Received
January 11, 2013
Report Date
December 5, 2012
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
FTL
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SHOULD ADDITIONAL INFO BECOME AVAILABLE REGARDING THIS EVENT IT WILL BE RE-ELEVATED AND A F/U REPORT WILL BE SENT AS APPROPRIATE. (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. THE DEVICE WAS IMPLANTED FOR TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
17924 SPARC SLING SYSTEM SURGICAL MESH FTL AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Disability