FDA Adverse Event Injury Summary report: N

AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM

MDR report key: 3172315 · Received April 24, 2013

Report

Report Number
1018233-2013-01488
Event Type
Injury
Date Received
April 24, 2013
Report Date
March 25, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
FTL
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
GA, US
Reporter Occupation
ATTORNEY

Narratives

Description of Event or Problem · 1

THE PATIENT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. ADDITIONAL INFORMATION HAS BEEN REQUESTED, BUT NOT YET RECEIVED. ASSOCIATED MDR: 1018233-2013-01489 AND 1018233-2013-01487.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
178008 AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM FTL SOFRADIM PRODUCTION NA PFG00395

Patients

Seq Age Sex Outcome Treatment
1 55 YR Required Intervention URETEX TO2 URETHRAL SUPPORT SYSTEM| AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM