MAUDE MDR 3356402

MDR report key
3356402
Report number
1018233-2013-03713
Event key
0
Event type
3
Date received
2013-08-23
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
LISA HALL
Address
8195 INDUSTRIAL BLVD COVINGTON GA 30014 US
Phone
770-770-7707
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ALIGN TO URETHRAL SUPPORT SYSTEM - HALOALIGN TO URETHRAL SUPPORT SYSTEM - HALOBARD SHANNON LIMITED -3005636544OTNNABRD500HLHUSB0928R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12013-08-2301. R

Event Narratives#

D

Patient 1

(B)(4). IT WAS REPORTED BY THE PT'S ATTORNEY THAT AS A RESULT OF HAVING THE PRODUCT IMPLANTED, THE PT HAS EXPERIENCED SIGNIFICANT SEVERE AND PERMANENT PHYSICAL PAIN, SUFFERING, DISABILITY, PHYSICAL IMPAIRMENT, SUSTAINED PERMANENT INJURY, AND HAS UNDERGONE MEDICAL TREATMENT.

N

Patient 1

THE PRODUCT FAMILY FOR THIS WOMEN'S HEALTHCARE PRODUCT IS UNK; THEREFORE, WE ARE UNABLE TO DETERMINE THE ASSOCIATED LABELING AND (B)(4) TO REVIEW. IF ADDITIONAL INFORMATION IS RECEIVED, A FOLLOW-UP REPORT WILL BE SUBMITTED. "LAWYER-FILED REPORT - (B)(6)."

N

Patient 1

THE SAMPLE WAS NOT RETURNED. THE FINISHED PRODUCT MET ALL SPECIFICATIONS PRIOR TO BEING RELEASED FOR GENERAL DISTRIBUTION. THE INSTRUCTIONS FOR USE WHICH ACCOMPANIES ALL DEVICES CURRENTLY ADDRESSES POTENTIAL RISKS ASSOCIATED WITH SURGICALLY IMPLANTED MATERIALS. THE INSTRUCTIONS FOR USE STATES IN THE ADVERSE EVENTS: COMPLICATIONS ASSOCIATED WITH THE PROPER IMPLANTATION OF THE ALIGN? TO URETHRAL SUPPORT SYSTEM MAY INCLUDE, BUT ARE NOT LIMITED TO: POSTOPERATIVE HEMATOMA, WHICH MAY OCCUR FOLLOWING THE IMPLANT PROCEDURE, TEMPORARY URINARY RETENTION, BLADDER OUTLET OBSTRUCTION, AND VOIDING DIFFICULTIES ASSOCIATED WITH OVER-CORRECTION/TOO MUCH TENSION PLACED ON THE MESH SLING IMPLANT, PERFORATIONS OR LACERATIONS OF VESSELS, NERVES, BLADDER OR ANY VISCERA, WHICH MAY OCCUR DURING INTRODUCER NEEDLE PASSAGE,TRANSITORY IRRITATION AT THE OPERATIVE WOUND SITE, WHICH MAY ELICIT A FOREIGN BODY RESPONSE THAT LEADS TO INFLAMMATION, INFECTION, OR EROSION OF THE IMPLANT. (B)(4).

D

Patient 1

PER ADDITIONAL INFORMATION RECEIVED, THE PATIENT HAS EXPERIENCED PELVIC PAIN, VAGINAL DRAINAGE, PAINFUL PRESSURE, PAINFUL INTERCOURSE, RECURRENCE OF THE ORIGINAL PROBLEM, MESH EROSION, MESH EXTRUSION, LEAKAGE WHEN SHE SNEEZES, URINARY PROBLEMS AND SLING EROSION WITH SUBSEQUENT EXCISION OF ERODED SLING. ADDITIONALLY HER BLADDER FEELS FULL ALL THE TIME AND SHE MUST GET UP IN THE MIDDLE OF THE NIGHT.