FDA Adverse Event Injury Summary report: N

PELVITEX POLYPROPYLENE MESH

MDR report key: 3152168 · Received May 24, 2013

Report

Report Number
1018233-2013-02144
Event Type
Injury
Date Received
May 24, 2013
Report Date
April 25, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
FTL
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
NY, US
Reporter Occupation
ATTORNEY

Narratives

Description of Event or Problem · 1

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
230632 PELVITEX POLYPROPYLENE MESH FTL SOFRADIM PRODUCTION NA PJB00393

Patients

Seq Age Sex Outcome Treatment
1 61 YR Required Intervention BOSTON SCIENTIFIC THE OBRYX TRANSOBTURATOR| NID - URETHRAL SLING SYSTEM