FDA Adverse Event Injury Summary report: N

ARIS TRANS-OBTURATOR

MDR report key: 3842774 · Received January 24, 2014

Report

Report Number
2125050-2014-00103
Event Type
Injury
Date Received
January 24, 2014
Date of Event
January 26, 2011
Report Date
January 23, 2014
Manufacturer
COLOPLAST A/S
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 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 AND NOVASILK MESH. LATER THE PT EXPERIENCED MESH EROSION AND EXPOSURE, VAGINAL INFECTION, SCARRING, INCONTINENCE, BLEEDING, PAIN, ORGAN PERFORATION, DYSPAREUNIA, NEUROMUSCULAR PROBLEMS AND LOSS OF CONSORTIUM FOR SPOUSE. EXCISIONS OF MESH, A COLONOSCOPY, LYSIS OF ADHESIONS AND CYSTOSCOPY WERE PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
55877 ARIS TRANS-OBTURATOR POLYMERIC SURGICAL MESH FTL COLOPLAST A/S 5195511400

Patients

Seq Age Sex Outcome Treatment
1 Other