FDA Adverse Event Injury Summary report: N

ARIS TRANS-OBTURATOR KIT

MDR report key: 3102898 · Received May 9, 2013

Report

Report Number
2125050-2013-00053
Event Type
Injury
Date Received
May 9, 2013
Report Date
May 9, 2013
Manufacturer
COLOPLAST A/S
Product Code
FTL
PMA / PMN Number
K050148
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

COLOPLAST HAS NOT BEEN PROVIDED ANY CORROBORATING EVIDENCE TO VERIFY THE INFORMATION IN THIS REPORT. DEVICE NOT RETURNED.

Description of Event or Problem · 1

AS REPORTED TO COLOPLAST THOUGH NOT VERIFIED, PATIENT IMPLANTED WITH ARIS TRANS OBTURATOR SLING ON (B)(6) 2006. LATER PATIENT EXPERIENCED EROSION, PAIN, BLADDER SPASMS AND CONTINUED URINARY INCONTINENCE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
204158 ARIS TRANS-OBTURATOR KIT PUBORUETHRAL SUPPORT TAPE FTL COLOPLAST A/S 5195501000

Patients

Seq Age Sex Outcome Treatment
1 Other