FDA Adverse Event
Injury
Summary report: N
URETEX SUP URETHRAL SUPPORT SYSTEM
MDR report key: 3192823
·
Received May 3, 2013
Report
- Report Number
- 1018233-2013-01718
- Event Type
- Injury
- Date Received
- May 3, 2013
- Report Date
- April 4, 2013
- Manufacturer
- SOFRADIM PRODUCTION
- Product Code
- OTN
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- MO, 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 RECEIVED, THE PT HAS EXPERIENCED PELVIC ORGAN PROLAPSE WITH CYSTOCELE RELATED TO BILATERAL PARAVAGINAL DEFECTS, VAGINAL VAULT PROLAPSE, PREVIOUS HYSTERECTOMY AND STRESS URINARY INCONTINENCE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 195746 | URETEX SUP URETHRAL SUPPORT SYSTEM | OTN | SOFRADIM PRODUCTION | NA | C23146SUP |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 48 YR | Required Intervention |