FDA Adverse Event Injury Summary report: N

URETEX TO URETHRAL SUPPORT SYSTEM

MDR report key: 3192767 · Received April 26, 2013

Report

Report Number
1018233-2013-01599
Event Type
Injury
Date Received
April 26, 2013
Report Date
March 29, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
FL, US
Reporter Occupation
ATTORNEY

Narratives

Description of Event or Problem · 1

THE PT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. PER ADD'L INFO REC'D, THE PT HAS EXPERIENCED RECTOCELE, ENTEROCELE AND PERINEAL LACERATION. ASSOCIATED MDR: 1018233-2013-01600 AND 1018233-2013-01601.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
183446 URETEX TO URETHRAL SUPPORT SYSTEM OTN SOFRADIM PRODUCTION NA UNK

Patients

Seq Age Sex Outcome Treatment
1 47 YR Required Intervention AVAULTA ANTERIOR BIOSYNTHETIC SUPPORT SYSTEM