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