FDA Adverse Event
Injury
Summary report: N
PARIETEX UGYTEX PP 15X10CM X1
MDR report key: 3111686
·
Received April 10, 2013
Report
- Report Number
- 9615742-2013-00246
- Event Type
- Injury
- Date Received
- April 10, 2013
- Date of Event
- September 10, 2007
- Report Date
- April 11, 2018
- Manufacturer
- SOFRADIM PRODUCTION
- Product Code
- FTL
- PMA / PMN Number
- K033376
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GA, US
- Reporter Occupation
- OTHER
- Health Professional
- N
Narratives
Additional Manufacturer Narrative · 1
(B)(4).
Description of Event or Problem · 1
PROCEDURE TYPE: UROGYNECOLOGICAL. ACCORDING TO THE REPORTER: THE PT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. PRODUCT WAS USED FOR THERAPEUTIC TREATMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 152389 | PARIETEX UGYTEX PP 15X10CM X1 | PELVITEX MESH | FTL | SOFRADIM PRODUCTION | PHB00211 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 43 YR | Female | Other |