FDA Adverse Event
Injury
Summary report: N
PELVITEX POLYPROPLYENE MESH
MDR report key: 3203753
·
Received March 27, 2013
Report
- Report Number
- 1018233-2013-00984
- Event Type
- Injury
- Date Received
- March 27, 2013
- Report Date
- February 26, 2013
- Manufacturer
- SOFRADIM PRODUCTION
- Product Code
- FTL
- Adverse Event
- Yes
- Report Source
- Distributor report
- Reporter Location
- NJ, US
- Reporter Occupation
- ATTORNEY
Narratives
Description of Event or Problem · 1
IT WAS REPORTED BY THE PT'S ATTORNEY THAT AS A RESULT OF HAVING THE PRODUCT IMPLANTED, THE PT HAS EXPERIENCED PAIN, INJURY, DISABILITY AND IMPAIRMENT. ASSOCIATED MDRS: 1018233-2013-00985 AND 1018233-2013-00986.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 127430 | PELVITEX POLYPROPLYENE MESH | FTL | SOFRADIM PRODUCTION | NA | P24162G3 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |