FDA Adverse Event Injury Summary report: N

DESARA

MDR report key: 3260850 · Received July 23, 2013

Report

Report Number
3003990090-2013-00317
Event Type
Injury
Date Received
July 23, 2013
Date of Event
November 1, 2010
Report Date
July 23, 2013
Manufacturer
CALDERA MEDICAL, INC.
Product Code
FTL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

EVENT WAS REPORTED TO CALDERA MEDICAL BY AN ATTORNEY. LEGAL COMPLAINT STATES THAT PATIENT SUFFERED SEVERE PAIN, RECURRING INFECTIONS, URINARY PROBLEMS AND CONTINUE INCONTINENCE. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
342279 DESARA SURGICAL MESH FTL CALDERA MEDICAL, INC.

Patients

Seq Age Sex Outcome Treatment
1 Other