FDA Adverse Event Injury Summary report: N

AMS ELEVATE ANTERIOR PROLAPSE REPAIR SYSTEM WITH INTEPRO LITE

MDR report key: 4093092 · Received September 16, 2014

Report

Report Number
2183959-2014-00411
Event Type
Injury
Date Received
September 16, 2014
Date of Event
December 14, 2012
Report Date
August 20, 2014
Manufacturer
AMERICAN MEDICAL SYSTEMS (MN)
Product Code
OTP
PMA / PMN Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THE PATIENT EXPERIENCED STRESS URINARY INCONTINENCE ONE MONTH AFTER AN ELEVATE PC ANTERIOR AND APICAL GRAFT WAS IMPLANTED. NO INTERVENTION HAD OCCURRED. THE EVENT WAS ONGOING AS OF (B)(6) 2014 NO FURTHER COMPLICATIONS WERE REPORTED IN RELATION TO THIS EVENT. RELATED TO MANUFACTURER REPORT NO. 2183959-2014-00412.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
573003 AMS ELEVATE ANTERIOR PROLAPSE REPAIR SYSTEM WITH INTEPRO LITE SURGICAL MESH OTP AMERICAN MEDICAL SYSTEMS (MN)

Patients

Seq Age Sex Outcome Treatment
1 Disability