FDA Adverse Event Injury Summary report: N

ADVANTAGE SYSTEM

MDR report key: 3250316 · Received July 26, 2013

Report

Report Number
3005099803-2013-06718
Event Type
Injury
Date Received
July 26, 2013
Report Date
July 1, 2013
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
OTN
PMA / PMN Number
K020110
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN ADVANTAGE TRANSVAGINAL MID-URETHRAL SLING SYSTEM WAS IMPLANTED ON (B)(6) 2008. ACCORDING TO THE COMPLAINANT, POST-PROCEDURE, THE PATIENT PRESENTED WITH UNSPECIFIED COMPLICATIONS. ALL OTHER INFORMATION IS UNKNOWN. SHOULD ADDITIONAL RELEVANT DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED FROM THE COMPLAINANT ON JUNE 08, 2016 NOTED THAT THE PATIENT EXPERIENCED INJURIES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
351504 ADVANTAGE SYSTEM MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC, FOR STRESS URINARY INCONTINENCE, RETR OTN BOSTON SCIENTIFIC - MARLBOROUGH M006850200051 0ML7082203

Patients

Seq Age Sex Outcome Treatment
1 Other