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 |