FDA Adverse Event Injury Summary report: N

MESH, SURGICAL, POLYMERIC

MDR report key: 3955920 · Received July 24, 2014

Report

Report Number
3005099803-2014-02601
Event Type
Injury
Date Received
July 24, 2014
Report Date
July 2, 2014
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINANT WAS UNABLE TO REPORT THE UPN AND LOT NUMBER; THEREFORE THE MANUFACTURE DATE AND EXPIRATION DATE ARE UNKNOWN. HOWEVER, THE COMPLAINANT STATED THAT THE DEVICE WAS USED PRIOR TO THE EXPIRATION DATE. THE COMPLAINANT INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A SLING WAS USED DURING AN UNKNOWN PROCEDURE ON AN UNKNOWN DATE. ACCORDING TO THE COMPLAINANT, RIGHT AFTER THE IMPLANTATION OF THE SLING, SHE BEGAN EXPERIENCING SEVERE PELVIC PAIN. IN 2010, HER DOCTOR REMOVED THE SLING AND IT "HELPED IMMENSELY". ALL OTHER INFORMATION IS UNKNOWN. SHOULD ADDITIONAL RELEVANT DETAILS BECOME AVAILABLE; A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
433336 MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH UNK677

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention