FDA Adverse Event Injury Summary report: N

URETEX SUPPORT PP TRANSOBTUR2 KIT X1

MDR report key: 3170560 · Received June 12, 2013

Report

Report Number
9615742-2013-00554
Event Type
Injury
Date Received
June 12, 2013
Date of Event
November 4, 2005
Report Date
May 20, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
PMA / PMN Number
K041176
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, 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 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
265847 URETEX SUPPORT PP TRANSOBTUR2 KIT X1 URETEX SUPPORT OTN SOFRADIM PRODUCTION SFG00272

Patients

Seq Age Sex Outcome Treatment
1 65 YR Other