FDA Adverse Event Injury Summary report: N

URETEX TO2 URETHRAL SUPPORT SYSTEM

MDR report key: 3213481 · Received May 8, 2013

Report

Report Number
1018233-2013-01805
Event Type
Injury
Date Received
May 8, 2013
Report Date
April 8, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
NY, 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, SUFFERING, DISABILITY AND IMPAIRMENT. ASSOCIATED MDR: 1018233-2013-01804 AND 1018233-2013-01811.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
202486 URETEX TO2 URETHRAL SUPPORT SYSTEM OTN SOFRADIM PRODUCTION NA SGA00194

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM| AVAULTA ANTERIOR BIOSYNTHETIC SUPPORT SYSTEM