FDA Adverse Event Injury Summary report: N

URETEX SUP URETHRAL SUPPORT SYSTEM

MDR report key: 3221123 · Received May 15, 2013

Report

Report Number
1018233-2013-01934
Event Type
Injury
Date Received
May 15, 2013
Report Date
April 15, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
GA, US
Reporter Occupation
ATTORNEY

Narratives

Description of Event or Problem · 1

(B)(4). THE PT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. ADD'L INFO HAS BEEN REQUESTED, BUT NOT YET RECEIVED. ASSOCIATED MDR: 1018233-2013-01936.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
215909 URETEX SUP URETHRAL SUPPORT SYSTEM OTN SOFRADIM PRODUCTION NA C24054SUP

Patients

Seq Age Sex Outcome Treatment
1 63 YR Required Intervention PELVICOL ACELLULAR COLLAGEN MATRIX