FDA Adverse Event Injury Summary report: N

MONARC SLING SYSTEM

MDR report key: 2926314 · Received January 16, 2013

Report

Report Number
2183959-2013-00289
Event Type
Injury
Date Received
January 16, 2013
Report Date
December 5, 2012
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
OTN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

LAWYER-FILED REPORT: (B)(4). SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE REGARDING THIS EVENT IT WILL BE RE-EVALUATED AND A FOLLOW-UP REPORT WILL BE SENT.

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.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
23220 MONARC SLING SYSTEM SURGICAL MESH OTN AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Disability