BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PARIETEX UGYTEX PP 15X10CM X1

    MDR report key: 3202341 · Received June 21, 2013

    Report

    Report Number
    9615742-2013-00574
    Event Type
    Injury
    Date Received
    June 21, 2013
    Date of Event
    March 4, 2008
    Report Date
    May 28, 2013
    Manufacturer
    SOFRADIM PRODUCTION
    Product Code
    FTL
    PMA / PMN Number
    K033376
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER
    Health Professional
    N

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). COVIDIEN IS SUBMITTING THIS REPORT ON BEHALF OF (B)(4)., (IMPORTER).

    Description of Event or Problem · 1

    PROCEDURE TYPE: ACCORDING TO THE REPORTER: THE PATIENT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. PRODUCT WAS USED FOR THERAPEUTIC TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    283352 PARIETEX UGYTEX PP 15X10CM X1 PELVITEX MESH FTL SOFRADIM PRODUCTION PHG00191

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Female Other ALIGN TO URETHRAL SUPPORT SYSTEM (B)(6) 2008