FDA Adverse Event
Injury
Summary report: N
MONARC SLING SYSTEM
MDR report key: 2922303
·
Received January 11, 2013
Report
- Report Number
- 2183959-2013-00124
- Event Type
- Injury
- Date Received
- January 11, 2013
- Manufacturer
- AMERICAN MEDICAL SYSTEMS, INC.
- Product Code
- OTN
- Report Source
- Manufacturer report
- Reporter Location
- TX, 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. LAWYER-FILED REPORT-(B)(4).
Description of Event or Problem · 1
IT WAS REPORTED BY THE PLAINTIFF'S ATTORNEY THAT THE PLAINTIFF EXPERIENCED EMOTIONAL DISTRESS AND A PROBLEM WITH THE PRODUCT. THE DEVICE WAS IMPLANTED FOR TREATMENT. RELATED TO MFR REPORT # 2183959-2013-00122, RELATED TO MFR REPORT # 2183959-2013-00123.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 17939 | MONARC SLING SYSTEM | SURGICAL MESH | OTN | AMERICAN MEDICAL SYSTEMS, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | APOGEE| IMPLANTED:| IMPLANTED:| PERIGEE| APOGEE| PERIGEE| IMPLANTED:| IMPLANTED: |