BEUDAMED
    FDA Adverse Event Injury Summary report: N

    APHI

    MDR report key: 293342 · Received August 30, 2000

    Report

    Report Number
    2125050-2000-00009
    Event Type
    Injury
    Date Received
    August 30, 2000
    Date of Event
    July 11, 2000
    Report Date
    August 30, 2000
    Manufacturer
    MENTOR CORPORATION - MINNESOTA DIVISION
    Product Code
    FWN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    FAILED PENILE PROSTHESIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 APHI INFLATABLE PENILE PROSTHESIS FWN MENTOR CORPORATION - MINNESOTA DIVISION NI NI

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Hospitalization| R