FDA Adverse Event
Injury
Summary report: N
ARIS TRANS-OBTURATOR
MDR report key: 3763942
·
Received October 7, 2013
Report
- Report Number
- 2125050-2013-00331
- Event Type
- Injury
- Date Received
- October 7, 2013
- Date of Event
- January 14, 2013
- Report Date
- October 7, 2013
- Manufacturer
- COLOPLAST MANUFACTURING US, LLC
- Product Code
- FTL
- PMA / PMN Number
- K050148
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- ATTORNEY
Narratives
Additional Manufacturer Narrative · 1
COLOPLAST HAS BOT BEEN PROVIDED NAY CORROBORATING EVIDENCE TO VERIFY THE INFORMATION CONTAINED IN THIS REPORT.
Description of Event or Problem · 1
AS REPORTED TO COLOPLAST THOUGH NOT VERIFIED, PATIENT WAS IMPLANTED WITH ARIS MESH. LATER THE PATIENT EXPERIENCED PAIN, INCONTINENCE, DYSPAREUNIA, SECONDARY PROLAPSE, URINARY DIFFICULTY AND OBSTRUCTION. A RELEASE OF MESH AND CYSTOCELE REPAIR WAS PERFORMED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 507525 | ARIS TRANS-OBTURATOR | POLYMERIC SURGICAL MESH | FTL | COLOPLAST MANUFACTURING US, LLC | 5195512400 | 2552434 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |