FDA Adverse Event Injury Summary report: N

ADVANTAGE SYSTEM

MDR report key: 2925725 · Received January 22, 2013

Report

Report Number
3005099803-2013-00289
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
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVENT DATE IS UNKNOWN; HOWEVER PATIENT WEIGHT WAS REPORTED AS (B)(6) LBS ON (B)(6) 2011.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT THE PATIENT WAS IMPLANTED WITH AN ADVANTAGE TRANSVAGINAL MID-URETHRAL SLING SYSTEM DURING A PROCEDURE ON (B)(6) 2008. ACCORDING TO THE COMPLAINANT, POST-PROCEDURE, THE PATIENT EXPERIENCED COMPLICATIONS (SPECIFICS UNKNOWN).ALL OTHER INFORMATION IS UNKNOWN. SHOULD ADDITIONAL RELEVANT DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

ACCORDING TO THE PHYSICIAN, ON (B)(6) 2012, THE PATIENT HAD NO ISSUES AND WAS DOING GREAT. ALL OTHER INFORMATION IS UNKNOWN AND UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
30603 ADVANTAGE SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH UNK557

Patients

Seq Age Sex Outcome Treatment
1 Other