FDA Adverse Event Injury Summary report: N

AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM

MDR report key: 3172323 · Received April 26, 2013

Report

Report Number
1018233-2013-01581
Event Type
Injury
Date Received
April 26, 2013
Report Date
March 28, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
FTL
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
AR, 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: 1018233-2013-01580.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
183253 AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM FTL SOFRADIM PRODUCTION NA ZGH00267

Patients

Seq Age Sex Outcome Treatment
1 53 YR Required Intervention URETEX TO3 URETHRAL SUPPORT SYSTEM