FDA Adverse Event Injury Summary report: N

AMS SPECTRA CONCEALABLE PENILE PROSTHESIS

MDR report key: 3182231 · Received June 14, 2013

Report

Report Number
2183959-2013-00869
Event Type
Injury
Date Received
June 14, 2013
Date of Event
May 7, 2013
Report Date
May 29, 2013
Manufacturer
AMERICAN MEDICAL SYSTEMS, INC.
Product Code
FAE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PR, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

SHOULD ADD'L INFO BECOME AVAILABLE REGARDING THIS EVENT, IT WILL BE RE-EVALUATED AND A FOLLOW-UP REPORT WILL BE SENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT HAD THE SPECTRA PENILE PROSTHESIS EXPLANTED DUE TO AN INFECTION AND REPLACED WITH ANOTHER SPECTRA. NO FURTHER PT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
271616 AMS SPECTRA CONCEALABLE PENILE PROSTHESIS PENILE PROSTHESIS FAE AMERICAN MEDICAL SYSTEMS, INC.

Patients

Seq Age Sex Outcome Treatment
1 74 YR Hospitalization| R