BEUDAMED
    FDA Adverse Event Injury Summary report: N

    0112770-BARD MESH LARGE PREFIX

    MDR report key: 467602 · Received June 18, 2003

    Report

    Report Number
    1213643-2003-00052
    Event Type
    Injury
    Date Received
    June 18, 2003
    Date of Event
    May 7, 2003
    Report Date
    May 23, 2003
    Manufacturer
    C.R. BARD, INC. (PUERTO RICO)
    Product Code
    FTL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT INFECTION. IMPLANTED IN 2001. EXPLANTED IN 2003 AT A DIFFERENT FACILITY. QUESTIONNAIRE SENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 0112770-BARD MESH LARGE PREFIX 350102102-MESH PLUGS FTL C.R. BARD, INC. (PUERTO RICO) * 43FKD309

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention