FDA Adverse Event Injury Summary report: N

ARIS TRANS-OBTURATOR

MDR report key: 3840747 · Received January 30, 2014

Report

Report Number
2125050-2014-00142
Event Type
Injury
Date Received
January 30, 2014
Date of Event
August 4, 2009
Report Date
January 30, 2014
Manufacturer
COLOPLAST A/S
Product Code
FTL
PMA / PMN Number
K050148
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

COLOPLAST HAS NOT BEEN PROVIDED ANY CORROBORATING EVIDENCE TO VERIFY THE INFO CONTAINED IN THIS REPORT.

Description of Event or Problem · 1

AS REPORTED TO COLOPLAST THOUGH NOT VERIFIED, PT WAS IMPLANTED WITH ARIS MESH. LATER THE PT EXPERIENCED FREQUENCY, LEAKING WITH COUGHING, MESH EXPOSURE AND RECURRENT URINARY INCONTINENCE. AN EXCISION OF THE MESH WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
65242 ARIS TRANS-OBTURATOR POLYMERIC SURGICAL MESH, PRODUCT CODE: FTL FTL COLOPLAST A/S 5195601400

Patients

Seq Age Sex Outcome Treatment
1 Other