FDA Adverse Event Injury Summary report: N

ADVANTAGE SYSTEM

MDR report key: 2924491 · Received January 22, 2013

Report

Report Number
3005099803-2013-00307
Event Type
Injury
Date Received
January 22, 2013
Report Date
December 31, 2012
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K020110
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN ADVANTAGE TRANSVAGINAL MID-URETHRAL SLING SYSTEM WAS IMPLANTED ON (B)(6), 2009.ACCORDING TO THE COMPLAINANT, POST-PROCEDURE, THE PATIENT PRESENTED WITH UNSPECIFIED COMPLICATIONS. ALL OTHER INFORMATION IS UNKNOWN. SHOULD ADDITIONAL RELEVANT DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
30384 ADVANTAGE SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH UNK557

Patients

Seq Age Sex Outcome Treatment
1 Other