FDA Adverse Event Injury Summary report: N

OBTRYX SYSTEM

MDR report key: 2972446 · Received February 21, 2013

Report

Report Number
3005099803-2013-00899
Event Type
Injury
Date Received
February 21, 2013
Report Date
February 1, 2013
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K040787
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

ACCORDING TO THE PHYSICIAN, POST PROCEDURE, THE PATIENT EXPERIENCED CONTINUED LEAKAGE. IN 2009 THE PATIENT UNDERWENT A DIFFERENT UNKNOWN PROCEDURE TO TREAT THE LEAKAGE. ALL OTHER INFORMATION IS UNKNOWN AND UNAVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN OBTRYX TRANSOBTURATOR MID-URETHRAL SLING SYSTEM WAS IMPLANTED ON (B)(6), 2007.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
75944 OBTRYX SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH UNK676

Patients

Seq Age Sex Outcome Treatment
1 Other