BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PELVICOL ACELLULAR AOLLAGEN MATRIX 4X7M

    MDR report key: 3231937 · Received July 11, 2013

    Report

    Report Number
    9617613-2013-00488
    Event Type
    Injury
    Date Received
    July 11, 2013
    Date of Event
    January 26, 2006
    Report Date
    May 7, 2018
    Manufacturer
    COVIDIEN
    Product Code
    FTL
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER
    Health Professional
    N

    Narratives

    Additional Manufacturer Narrative · 1

    TRACKING NUMBER: (B)(4).

    Description of Event or Problem · 1

    PROCEDURE: STRESS UI/PELVIC ORGAN PROLAPSE. ACCORDING TO THE REPORTER: THE PATIENT ALLEGED INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    319973 PELVICOL ACELLULAR AOLLAGEN MATRIX 4X7M PELVICOL MESH FTL COVIDIEN 04B23-9

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Female Other