FDA Adverse Event Injury Summary report: N

URETEX TO2 URETHRAL SUPPORT SYSTEM

MDR report key: 3221162 · Received May 17, 2013

Report

Report Number
1018233-2013-02088
Event Type
Injury
Date Received
May 17, 2013
Report Date
April 19, 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. ADDITIONAL INFO HAS BEEN REQUESTED, BUT NOT YET RECEIVED. ASSOCIATED MDR: 1018233-2013-02087 AND 1018233-2013-02089.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
220108 URETEX TO2 URETHRAL SUPPORT SYSTEM OTN SOFRADIM PRODUCTION NA UNK

Patients

Seq Age Sex Outcome Treatment
1 38 YR Required Intervention AVAULTA ANTERIOR BIOSYNTHETIC SUPPORT SYSTEM| AVAULTA POSTERIOR BIOSYNTHETIC SUPPORT SYSTEM