FDA Adverse Event Injury Summary report: N

URETEX SUPPORT PP TRANSOBTUR KIT X1

MDR report key: 3250753 · Received July 19, 2013

Report

Report Number
9615742-2013-00875
Event Type
Injury
Date Received
July 19, 2013
Date of Event
October 21, 2004
Report Date
July 1, 2013
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
PMA / PMN Number
K041176
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

PROCEDURE TYPE: UROGYNECOLOGICAL. ACCORDING TO THE RPTR: THE PT ALLEGED INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
338063 URETEX SUPPORT PP TRANSOBTUR KIT X1 URETEX SUPPORT OTN SOFRADIM PRODUCTION 24230TO

Patients

Seq Age Sex Outcome Treatment
1 28 YR Other