FDA Adverse Event Injury Summary report: N

MINIARC SINGLE-INCISION SLING

MDR report key: 2926321 · Received January 16, 2013

Report

Report Number
2183959-2013-00304
Event Type
Injury
Date Received
January 16, 2013
Report Date
December 5, 2012
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
PAH
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DE, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SHOULD ADDITIONAL INFO BECOME AVAILABLE REGARDING THIS EVENT IT WILL BE RE-EVALUATED AND A FOLLOW-UP 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 AN UNSPECIFIED INJURY AND A PROBLEM WITH THE PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
25113 MINIARC SINGLE-INCISION SLING SURGICAL MESH PAH AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Disability