FDA Adverse Event Injury Summary report: N

AMS SPECTRA CONCEALABLE PENILE PROSTHESIS

MDR report key: 3032239 · Received March 29, 2013

Report

Report Number
2183959-2013-00767
Event Type
Injury
Date Received
March 29, 2013
Date of Event
August 3, 2012
Report Date
March 12, 2013
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
FAE
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
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 ENTIRE MALLEABLE MODEL PENILE PROSTHESIS WAS REMOVED DUE TO PATIENT DISSATISFACTION AND REPLACED WITH AN INFLATABLE MODEL PENILE PROSTHESIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
131168 AMS SPECTRA CONCEALABLE PENILE PROSTHESIS PENILE PROSTHESIS FAE AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 42 YR Hospitalization| R