FDA Adverse Event
Injury
Summary report: N
AMS SPECTRA CONCEALABLE PENILE PROSTHESIS
MDR report key: 3032238
·
Received March 29, 2013
Report
- Report Number
- 2183959-2013-00771
- Event Type
- Injury
- Date Received
- March 29, 2013
- Report Date
- January 24, 2013
- Manufacturer
- AMERICAN MEDICAL SYSTEMS, INC.
- Product Code
- FAE
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UT, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE REGARDING THIS EVENT IT WILL BE RE-EVALUATED AND A FOLLOW-UP REPORT WILL BE SENT.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE DEVICE WAS REMOVED AND REPLACED WITH AN AMS INFLATABLE PENILE PROSTHESIS. THE DATE AND REASON FOR THE REMOVAL WERE REQUESTED, BUT NOT PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 129925 | AMS SPECTRA CONCEALABLE PENILE PROSTHESIS | PENILE PROSTHESIS | FAE | AMERICAN MEDICAL SYSTEMS, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |