FDA Adverse Event
Injury
Summary report: N
URETEX SUPPORT PP KIT XL
MDR report key: 3411057
·
Received October 4, 2013
Report
- Report Number
- 9615742-2013-01892
- Event Type
- Injury
- Date Received
- October 4, 2013
- Date of Event
- July 11, 2006
- Report Date
- September 16, 2013
- Manufacturer
- SOFRADIM PRODUCTION
- Product Code
- OTN
- PMA / PMN Number
- K012949
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MO, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). COVIDIEN IS SUBMITTING THIS REPORT ON BEHALF OF C.R. BARD, INC.
Description of Event or Problem · 1
PROCEDURE: UROGYNECOLOGICAL. ACCORDING TO THE REPORTER: THE PT ALLEGED INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 502500 | URETEX SUPPORT PP KIT XL | URETEX SUPPORT | OTN | SOFRADIM PRODUCTION |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |