FDA Adverse Event Injury Summary report: N

PARIETEX UGYTEX PP POSTERIOR KIT X1

MDR report key: 3131343 · Received May 17, 2013

Report

Report Number
9615742-2013-00427
Event Type
Injury
Date Received
May 17, 2013
Date of Event
August 10, 2006
Report Date
May 8, 2018
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTP
PMA / PMN Number
K051503
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
220058 PARIETEX UGYTEX PP POSTERIOR KIT X1 AVAULTA POSTERIOR SYSTEM OTP SOFRADIM PRODUCTION ZGE00582

Patients

Seq Age Sex Outcome Treatment
1 39 YR Female Other UGYKA PARIETEX UGYTEX PP ANTERIOR KIT X1: ZGC00156, EXP: 03/31/2011, MFR: 03/2006| PARIETEX UGYTEX PP ANTERIOR KIT X1: (B)(4)| EXP: 03/31/2011, MFR: 03/2006| UGYKA