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 |