FDA Adverse Event Injury Summary report: N

URETEX SUPPORT PP KIT X1

MDR report key: 3231942 · Received July 11, 2013

Report

Report Number
9615742-2013-00753
Event Type
Injury
Date Received
July 11, 2013
Date of Event
December 12, 2005
Report Date
June 17, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
PMA / PMN Number
K012949
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 URINARY INCONTINENCE ACCORDING TO THE REPORTER: THE PATIENT ALLEGED INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
320797 URETEX SUPPORT PP KIT X1 URETEX OTN SOFRADIM PRODUCTION SFG00099

Patients

Seq Age Sex Outcome Treatment
1 53 YR Female Other