BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM

    MDR report key: 3203737 · Received March 26, 2013

    Report

    Report Number
    1018233-2013-00869
    Event Type
    Injury
    Date Received
    March 26, 2013
    Report Date
    February 25, 2013
    Manufacturer
    SOFRADIM PRODUCTION
    Product Code
    FTL
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    GA, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    THE PT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. ADDITIONAL INFO HAS BEEN REQUESTED, BUT NOT YET RECEIVED. ASSOCIATED MDR 1018233-2013-00870.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    125410 AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM FTL SOFRADIM PRODUCTION NA PFG00395

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Required Intervention PELVILACE TO BIOURETHRAL SUPPORT SYSTEM