FDA Adverse Event
Injury
Summary report: N
GYNECARE TVT OBTURATOR
MDR report key: 9271854
·
Received November 4, 2019
Report
- Report Number
- 2210968-2019-89440
- Event Type
- Injury
- Date Received
- November 4, 2019
- Date of Event
- May 5, 2018
- 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 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 3928787 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 (B)(6) 2017 AND THE MESH WAS IMPLANTED. POST-OP, THE PATIENT EXPERIENCED URINARY LOSS, UNABLE TO HAVE SEX, AND SOMETIMES VAGINAL INFECTION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1066917 | GYNECARE TVT OBTURATOR | MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC | OTN | ETHICON INC. | 3928787 | 10705031000346 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |