FDA Adverse Event
Malfunction
Summary report: N
SURGITEK UNIFLATE PENILE IMPLANT
MDR report key: 36822
·
Received September 3, 1996
Report
- Report Number
- 2182596-1996-00010
- Event Type
- Malfunction
- Date Received
- September 3, 1996
- Report Date
- August 28, 1996
- Manufacturer
- MEDICAL ENGINEERING CORP.
- Product Code
- FHW
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- DC, US
- Reporter Occupation
- ATTORNEY
Narratives
Description of Event or Problem · 1
LEFT TUBING SEPARATED FROM RESERVOIR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SURGITEK UNIFLATE PENILE IMPLANT Implant | TWO-PART INFLATABLE PENILE IMPLANT | FHW | MEDICAL ENGINEERING CORP. | UNK | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Required Intervention |