FDA Adverse Event Injury Summary report: N

GYNECARE TVT OBURATOR SYSTEM

MDR report key: 3242551 · Received July 23, 2013

Report

Report Number
2210968-2013-14115
Event Type
Injury
Date Received
July 23, 2013
Report Date
July 11, 2016
Manufacturer
ETHICON INC.
Product Code
OTN
PMA / PMN Number
K033568
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
RI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4) ¿URINARY PROBLEMS; UNDEFINED RECURRENCE. ADDITIONAL NARRATIVE: IT WAS REPORTED THAT FOLLOWING INSERTION THE PATIENT EXPERIENCED PAIN, EROSION, EXTRUSION, URINARY PROBLEMS, RECURRENCE, DYSPAREUNIA, ANXIETY, AND VAGINAL SCARRING. IT WAS REPORTED THAT THE PATIENT UNDERWENT EXCISION OF EXPOSED MESH WITH VAGINAL REPAIR ON (B)(6) 2011. NO ADDITIONAL INFORMATION WAS PROVIDED.

Additional Manufacturer Narrative · 1

(B)(4). IN ADDITION, A REVIEW OF THE BATCH MANUFACTURING RECORDS WAS CONDUCTED AND THE BATCH MET ALL FINISHED GOODS RELEASE CRITERIA.

Additional Manufacturer Narrative · 1

(B)(4). CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A SUPPLEMENTAL 3500A FORM WILL BE SUBMITTED ACCORDINGLY.

Additional Manufacturer Narrative · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE AND MESH WAS IMPLANTED ALONG WITH CONCURRENT ENTEROLYSIS DUE TO CHRONIC PELVIC PAIN AND SUI. (B)(4).

Additional Manufacturer Narrative · 1

IT WAS REPORTED THAT FOLLOWING INSERTION THE PATIENT EXPERIENCED URINARY RETENTION, DISCOMFORT, URINARY FREQUENCY. NO ADDITIONAL INFORMATION WAS PROVIDED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE ON (B)(6) 2011 AND MESH WAS IMPLANTED. IT WAS REPORTED THAT SHE EXPERIENCED PAIN, EROSION OF HER INTERNAL BODILY TISSUE AND OTHER INJURIES FOLLOWING THE PROCEDURE. IT WAS REPORTED THAT THE PATIENT HAS UNDERGONE MULTIPLE SURGERIES AND REVISIONARY PROCEDURES. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
344046 GYNECARE TVT OBURATOR SYSTEM MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC OTN ETHICON INC. UNK 3475371

Patients

Seq Age Sex Outcome Treatment
1 34 YR Required Intervention