FDA Adverse Event Injury Summary report: N

ALIGNTM S URETHRAL SUPPORT SYSTEM SUPRAPUBIC

MDR report key: 3132746 · Received May 16, 2013

Report

Report Number
1018233-2013-02049
Event Type
Injury
Date Received
May 16, 2013
Report Date
June 28, 2017
Manufacturer
C.R. BARD, INC. (COVINGTON)
Product Code
OTN
UDI-DI
00801741016189
PMA / PMN Number
K070073
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
ATTORNEY
Health Professional
N

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE WAS NOT RETURNED. THE FINISHED PRODUCT MET ALL SPECIFICATIONS PRIOR TO BEING RELEASED FOR GENERAL DISTRIBUTION . THE INSTRUCTIONS FOR USE WHICH ACCOMPANIES ALL DEVICES CURRENTLY ADDRESSES POTENTIAL RISKS ASSOCIATED WITH SURGICALLY IMPLANTED MATERIALS. THE INSTRUCTIONS FOR USE STATES IN THE ADVERSE EVENTS: "COMPLICATIONS ASSOCIATED WITH THE PROPER IMPLANTATION OF THE ALIGN TO URETHRAL SUPPORT SYSTEM MAY INCLUDE, BUT ARE NOT LIMITED TO: POSTOPERATIVE HEMATOMA, WHICH MAY OCCUR FOLLOWING THE IMPLANT PROCEDURE. TEMPORARY URINARY RETENTION, BLADDER OUTLET OBSTRUCTION AND VOIDING DIFFICULTIES ASSOCIATED WITH OVERCORRECTION/TOO MUCH TENSION PLACED ON THE SLING IMPLANT. PERFORATIONS OR LACERATIONS OF VESSELS, NERVES, BLADDER, OR ANY VISCERA, WHICH MAY OCCUR DURING INTRODUCER NEEDLE PASSAGE. TRANSITORY IRRITATION AT THE OPERATIVE WOUND SITE, WHICH MAY ELICIT A FOREIGN BODY RESPONSE THAT LEADS TO INFLAMMATION, INFECTION, OR EROSION OF THE IMPLANT." (B)(4).

Description of Event or Problem · 1

THE PT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. ADD'L INFO HAS BEEN REQUESTED, BUT NOT YET REC'D. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
218780 ALIGNTM S URETHRAL SUPPORT SYSTEM SUPRAPUBIC NO MATCH OTN C.R. BARD, INC. (COVINGTON) NA CVRG0032 00801741016189
218781 ALIGNTM S URETHRAL SUPPORT SYSTEM SUPRAPUBIC NO MATCH OTN C.R. BARD, INC. (COVINGTON) NA CVRG0032 00801741016189

Patients

Seq Age Sex Outcome Treatment
1 41 YR Female Required Intervention