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