FDA Adverse Event Injury Summary report: N

UNKNOWN URETEX MESH PRODUCT

MDR report key: 3955098 · Received July 22, 2014

Report

Report Number
9615742-2014-00231
Event Type
Injury
Date Received
July 22, 2014
Date of Event
June 2, 2003
Report Date
July 9, 2014
Manufacturer
SOFRADIM PRODUCTION
Product Code
OTN
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). COVIDIEN IS SUBMITTING THE REPORT ON BEHALF OF (B)(4) (IMPORTER).

Description of Event or Problem · 1

ACCORDING TO THE REPORTER: THE PT ALLEGED INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
428911 UNKNOWN URETEX MESH PRODUCT NONE OTN SOFRADIM PRODUCTION NOT AVAILABLE

Patients

Seq Age Sex Outcome Treatment
1 46 YR Other