BEUDAMED
    FDA Adverse Event Injury Summary report: N

    URETEX SUPPORT PP TRANSOBTURATOR1 KIT X1

    MDR report key: 3143071 · Received May 24, 2013

    Report

    Report Number
    9615742-2013-00485
    Event Type
    Injury
    Date Received
    May 24, 2013
    Date of Event
    September 26, 2009
    Report Date
    May 2, 2013
    Manufacturer
    SOFRADIM PRODUCTION
    Product Code
    OTN
    PMA / PMN Number
    K041176
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    PROCEDURE TYPE: UROGYNECOLOGICAL. ACCORDING TO THE REPORTER: THE PATIENT'S ATTORNEY THAT AS A RESULT OF HAVING THE PRODUCT IMPLANTED, THE PATIENT HAS EXPERIENCED PAIN, DISABILITY AND IMPAIRMENT. PRODUCT WAS USED FOR THERAPEUTIC TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    231297 URETEX SUPPORT PP TRANSOBTURATOR1 KIT X1 URETEX SUPPORT OTN SOFRADIM PRODUCTION SFK00448

    Patients

    Seq Age Sex Outcome Treatment
    1 Other