FDA Adverse Event Injury Summary report: N

GYNECARE TVT OBTURATOR

MDR report key: 9263174 · Received October 31, 2019

Report

Report Number
2210968-2019-89339
Event Type
Injury
Date Received
October 31, 2019
Date of Event
April 13, 2016
Report Date
October 7, 2019
Manufacturer
ETHICON INC.
Product Code
OTN
UDI-DI
10705031000346
PMA / PMN Number
K033568
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). A REVIEW OF THE BATCH MANUFACTURING RECORDS WAS CONDUCTED AND THE BATCH MET ALL FINISHED GOODS RELEASE CRITERIA FOR LOT 3669088 AND PRODUCT CODE 810081. TO DATE THE DEVICE HAS NOT BEEN RETURNED. IF THE DEVICE OR FURTHER DETAILS ARE RECEIVED AT THE LATER DATE A SUPPLEMENTAL MEDWATCH WILL BE SENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT A GYNECOLOGICAL PROCEDURE ON 4/13/2013 AND THE MESH WAS IMPLANTED. POST-OP, THE PATIENT EXPERIENCED CHRONIC URINARY INFECTION/CYSTIC AND MORE. NO FURTHER INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1056936 GYNECARE TVT OBTURATOR MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC OTN ETHICON INC. 3669088 10705031000346

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention