BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TITAN TOUCH SCRO ZERO ANG 20CM

    MDR report key: 7716278 · Received July 24, 2018

    Report

    Report Number
    2125050-2018-00544
    Event Type
    Injury
    Date Received
    July 24, 2018
    Date of Event
    June 21, 2018
    Report Date
    August 2, 2018
    Manufacturer
    COLOPLAST A/S
    Product Code
    FHW
    UDI-DI
    05708932539197
    PMA / PMN Number
    P000006
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 0

    THIS FOLLOW-UP MDR IS CREATED TO DOCUMENT THE CONCLUSION OF THE INVESTIGATION. REQUESTS FOR THE EXPLANTED PROSTHESIS AND FOR ADDITIONAL INFORMATION SURROUNDING THIS EVENT HAVE BEEN MADE. HOWEVER, TO DATE NEITHER THE DEVICE NOR THE INFORMATION HAS BEEN RECEIVED. WITHOUT THE BENEFIT OF ANALYZING THE EXPLANT AND WITHOUT THE REQUESTED INFORMATION, QUALITY CANNOT COMMENT ON THE CONDITION OF THE DEVICE OR THE EVENTS SURROUNDING THIS INCIDENT. IF THE EXPLANTED DEVICE OR ADDITIONAL INFORMATION IS RECEIVED, QUALITY WILL RE-EVALUATE THIS EVENT IN ACCORDANCE WITH PROCEDURES. QUALITY REVIEWED THE MANUFACTURING RECORDS FOR THIS DEVICE AND CONFIRMED THAT THERE WERE NO DISCREPANCIES THAT WOULD HAVE CONTRIBUTED TO THIS COMPLAINT AND VERIFIED THAT THE DEVICES FROM THIS LOT MET ALL SPECIFICATIONS PRIOR TO RELEASE. A REVIEW OF THE COMPLAINT HISTORY DATABASE REVEALED NO ADDITIONAL COMPLAINTS FOR LOT 4241684. REVIEW OF NONCONFORMING REPORTS REVEALED NO NONCONFORMANCE'S FOR THIS LOT. NO CAPAS ARE ASSOCIATED WITH THIS LOT. MANAGEMENT ROUTINELY REVIEWS EVENTS SUCH AS THIS AND MONITORS COMPLAINT LEVELS. ADDITIONALLY, EVENTS OF THIS TYPE ARE CAPTURED IN THE PRODUCT RISK DOCUMENTATION. BASED ON THIS INFORMATION NO FURTHER CORRECTIVE ACTION IS REQUIRED AT THIS TIME.

    Additional Manufacturer Narrative · 1

    WITHOUT THE BENEFIT OF EXAMINATION AND TESTING, COLOPLAST IS PRECLUDED FROM COMMENTING ON THE CONDITION OF THE DEVICE OR THE CAUSE OF THE OCCURRENCE. ONCE OUR EVALUATION IS COMPLETE, A FOLLOW-UP REPORT WILL BE SUBMITTED.

    Description of Event or Problem · 1

    ACCORDING TO THE AVAILABLE INFORMATION, MALFUNCTION - PUMP COLLAPSE, R/O LEAK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    555896 TITAN TOUCH SCRO ZERO ANG 20CM INFLATABLE PENILE PROSTHESIS FHW COLOPLAST A/S ES29202400 4241684 05708932539197

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Other