FDA Adverse Event Injury Summary report: N

ALIGN R RETROPUBIC URETHRAL SUPPORT SYSTEM

MDR report key: 2993878 · Received March 1, 2013

Report

Report Number
1018233-2013-00645
Event Type
Injury
Date Received
March 1, 2013
Report Date
November 3, 2015
Manufacturer
BARD SHANNON LIMITED
Product Code
FTL
PMA / PMN Number
K070073
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
ATTORNEY
Health Professional
N

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE WAS NOT RETURNED. THE FINISHED PRODUCT MET ALL SPECIFICATIONS PRIOR TO BEING RELEASED FOR GENERAL DISTRIBUTION. THE INSTRUCTIONS FOR USE WHICH ACCOMPANIES ALL DEVICES CURRENTLY ADDRESSES POTENTIAL RISKS ASSOCIATED WITH SURGICALLY IMPLANTED MATERIALS. THE INSTRUCTIONS FOR USE STATES IN THE ADVERSE EVENTS: "COMPLICATIONS ASSOCIATED WITH THE PROPER IMPLANTATION OF THE ALIGN URETHRAL SUPPORT SYSTEM MAY INCLUDE, BUT ARE NOT LIMITED TO: POSTOPERATIVE HEMATOMA, WHICH MAY OCCUR FOLLOWING THE IMPLANT PROCEDURE. TEMPORARY URINARY RETENTION, BLADDER OUTLET OBSTRUCTION, AND VOIDING DIFFICULTIES ASSOCIATED OVER-CORRECTION/TOO MUCH TENSION PLACED ON THE MESH SLING IMPLANT. PERFORATIONS OR LACERATIONS OF VESSELS, NERVES, BLADDER OR ANY VISCERA, WHICH MAY OCCUR DURING INTRODUCER NEEDLE PASSAGE. TRANSITORY IRRITATION AT THE OPERATIVE WOUND SITE, WHICH MAY ELICIT A FOREIGN BODY RESPONSE THAT LEADS TO INFLAMMATION, INFECTION, OR EROSION OF THE IMPLANT." (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED BY THE PATIENT'S ATTORNEY THAT AS A RESULT OF HAVING THE PRODUCT IMPLANTED, THE PATIENT HAS EXPERIENCED PAIN, SUFFERING, DISABILITY, AND IMPAIRMENT. ASSOCIATED MDR: 1018233-2013-00644.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
89398 ALIGN R RETROPUBIC URETHRAL SUPPORT SYSTEM Mesh, surgical, polymeric FTL BARD SHANNON LIMITED NA HUTF0304

Patients

Seq Age Sex Outcome Treatment
1 Female Required Intervention AVAULTA SOLO ANTERIOR SYNTHETIC SUPPORT SYSTEM| AVAULTA SOLO ANTERIOR SYNTHETIC SUPPORT SYSTEM