FDA Adverse Event Injury Summary report: N

TENSION FREE VAGINAL TAPE

MDR report key: 3161634 · Received June 11, 2013

Report

Report Number
2210968-2013-06951
Event Type
Injury
Date Received
June 11, 2013
Report Date
May 20, 2013
Manufacturer
ETHICON, INC.
Product Code
FTL
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CALCULI OCCURED. URINARY RETENTION OCCURED. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT A SLING PROCEDURE WITH A PROLAPSE REPAIR. THE PATIENT EXPERIENCED VOIDING DIFFICULTY AND RECURRENT URINARY TRACT INFECTIONS. A SMALL CALCULI WAS SEEN IN THE PROXIMAL URETHRA ON CYSTOSCOPY. IT WAS NOT SEEN ON EUA, BUT THE SLING WAS TIGHT. THE PATIENT UNDERWENT A DIVISION OF THE MESH AND AN EXCISION OF THE SUBURETHRAL PORTION OF MESH. ADDITIONAL INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
261850 TENSION FREE VAGINAL TAPE MESH, SURGICAL, POLYMERIC FTL ETHICON, INC. NA NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention