BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GYNECARE PROLIFT +M POSTERIOR PELVIC FLOOR REPAIR SYSTEM

    MDR report key: 3213871 · Received July 9, 2013

    Report

    Report Number
    2210968-2013-12641
    Event Type
    Injury
    Date Received
    July 9, 2013
    Report Date
    June 7, 2016
    Manufacturer
    ETHICON INC.
    Product Code
    OTP
    PMA / PMN Number
    K071512
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE AND MESH WAS IMPLANTED DUE TO POP, LARGE POSTERIOR AND APICAL COMPARTMENT DEFECTS AND MIXED URINARY INCONTINENCE.

    Additional Manufacturer Narrative · 1

    (B)(4): NO CONCLUSION CAN BE DRAWN AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY.

    Additional Manufacturer Narrative · 1

    (B)(4).IN ADDITION, A REVIEW OF THE BATCH MANUFACTURING RECORDS WAS CONDUCTED AND THE BATCH MET ALL FINISHED GOODS RELEASE CRITERIA.(B)(4).

    Additional Manufacturer Narrative · 1

    (B)(4). IT WAS REPORTED THAT FOLLOWING INSERTION THE PATIENT EXPERIENCED PAIN, EROSION, INFECTION, URINARY PROBLEMS AND DYSPAREUNIA. IT WAS REPORTED THAT PATIENT UNDERWENT MESH REVISION POSTERIOR COLPORRHAPHY WITH EXCISION OF EXPOSED MESH ON (B)(6) 2010 AND (B)(6) 2013 DUE TO SYMPTOMATIC VAGINAL MESH EXPOSURE. NO ADDITIONAL INFORMATION WAS PROVIDED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE; MESH-ENHANCED POSTERIOR COLPORRHAPHY, SACROSPINOUS APICAL VAGINAL VAULT SUSPENSION (MESH), MESH AND CYSTOSCOPY, FOR STRESS URINARY INCONTINENCE, GRADE III ANTERIOR AND POSTERIOR VAGINAL COMPARTMENT DEFECT, ENTEROCELE, RECTOCELE, ON (B)(6) 2009 AND MESHY WERE IMPLANTED INTO THE PATIENT. IT IS ALSO REPORTED THAT THE PATIENT EXPERIENCED PAIN, EROSION OF HER INTERNAL TISSUES, AND SHE HAS UNDERGONE ADDITIONAL SURGERIES AND REVISIONARY PROCEDURES. NO ADDITIONAL INFORMATION IS PROVIDED AT THIS TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    313246 GYNECARE PROLIFT +M POSTERIOR PELVIC FLOOR REPAIR SYSTEM MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC OTP ETHICON INC. 3270183

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Required Intervention