MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05 report with the FDA on 2013-09-25 for AMS SPHINCTER 800 URINARY PROSTHESIS 72404134 manufactured by American Medical Systems, Inc..
[3929727]
It was reported that the patient had his 2 artificial urinary sphincter cuffs replaced due to recurring incontinence. No further patient complications were reported.
Patient Sequence No: 1, Text Type: D, B5
[11218843]
Cuff #2: date implanted (b)(6) 2012, catalog # 72404130, lot/sn #(b)(4), expiration date 03/27/2013, manufacture date: 03/01/2012. Should additional information become available regarding this event it will be re-evaluated and a follow up report will be sent.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2183959-2013-01042 |
| MDR Report Key | 3378176 |
| Report Source | 01,05 |
| Date Received | 2013-09-25 |
| Date of Report | 2013-03-25 |
| Date of Event | 2013-01-08 |
| Date Mfgr Received | 2013-03-25 |
| Device Manufacturer Date | 2010-05-01 |
| Date Added to Maude | 2013-10-02 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | SHARON ZURN, DIRECTOR |
| Manufacturer Street | 10700 BREN RD., WEST |
| Manufacturer City | MINNETONKA MN 55343 |
| Manufacturer Country | US |
| Manufacturer Postal | 55343 |
| Manufacturer Phone | 9529306347 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | AMS SPHINCTER 800 URINARY PROSTHESIS |
| Generic Name | ARTIFICIAL URINARY SPHINCTER |
| Product Code | FAG |
| Date Received | 2013-09-25 |
| Catalog Number | 72404134 |
| Lot Number | 651902001 |
| Device Expiration Date | 2012-05-04 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | AMERICAN MEDICAL SYSTEMS, INC. |
| Manufacturer Address | 10700 BREN RD., WEST MINNETONKA MN 55343 US 55343 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization; 2. Required No Informationntervention | 2013-09-25 |