FDA Adverse Event Injury Summary report: N

ARIS TRANS-OBTURATOR

MDR report key: 3840750 · Received January 30, 2014

Report

Report Number
2125050-2014-00141
Event Type
Injury
Date Received
January 30, 2014
Date of Event
September 12, 2012
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 VERIFIED, PT WAS IMPLANTED WITH ARIS MESH. LATER THE PT EXPERIENCED INCOMPLETE EMPTYING AND STRAINING TO VOID, DYSPAREUNIA, BLADDER OUTLET OBSTRUCTION AND MESH EXTRUSION. AN EXCISION OF THE MESH, RIGID CYSTOSCOPY, POSTERIOR COLPORRHAPHY AND PERINEAL BODY REPAIR WERE PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
65243 ARIS TRANS-OBTURATOR POLYMERIC SURGICAL MESH, PRODUCT CODE: FTL FTL COLOPLAST A/S 5195501400

Patients

Seq Age Sex Outcome Treatment
1 Other