FDA Adverse Event Injury Summary report: N

PINNACLE PELVIC FLOOR REPAIR KITS

MDR report key: 3250279 · Received July 26, 2013

Report

Report Number
3005099803-2013-06673
Event Type
Injury
Date Received
July 26, 2013
Report Date
July 1, 2013
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K071957
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THE IMPLANT DATE WAS REPORTED TO BE APPROXIMATELY (B)(6) 2010. HOWEVER, THIS MAY NOT BE THE EXACT DATE.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A PINNACLE ANTERIOR-APICAL PELVIC FLOOR REPAIR KIT WAS IMPLANTED INTO THE PATIENT ON APPROXIMATELY (B)(6) 2010. ACCORDING TO THE COMPLAINANT, THE PATIENT EXPERIENCED INJURIES (SPECIFICS UNKNOWN). ALL OTHER INFORMATION, INCLUDING THE PATIENT'S CURRENT CONDITION, IS UNKNOWN AND UNAVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
351189 PINNACLE PELVIC FLOOR REPAIR KITS MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH M0068317050

Patients

Seq Age Sex Outcome Treatment
1 Other