FDA Adverse Event Injury Summary report: N

BONE ANCHOR SYSTEM FOR SOFT TISSUE SUPPORT

MDR report key: 2962549 · Received February 14, 2013

Report

Report Number
3005099803-2013-00818
Event Type
Injury
Date Received
February 14, 2013
Report Date
January 29, 2013
Manufacturer
BOSTON SCIENTIFIC - SPENCER
Product Code
MBI
PMA / PMN Number
K971139
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A VESICA SLING SYSTEM WAS IMPLANTED ON (B)(6), 2001.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
65932 BONE ANCHOR SYSTEM FOR SOFT TISSUE SUPPORT FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE MBI BOSTON SCIENTIFIC - SPENCER M0068201300 4446250

Patients

Seq Age Sex Outcome Treatment
1 Other