MAUDE MDR 3535704

MDR report key
3535704
Report number
1018233-2013-09709
Event key
0
Event type
3
Date received
2013-12-13
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
600
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
CHRISTY LEWIS
Address
8195 INDUSTRIAL BOULEVARD 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 R URETHRAL SUPPORT SYSTEMBARD SHANNON LIMITEDOTNNABRD100RHUSI2202R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12013-12-1301. R

Event Narratives#

D

Patient 1

THE PT'S ATTORNEY ALLEGED A DEFICIENCY AGAINST THE DEVICE. ADD'L INFO HAS BEEN REQUESTED, BUT NOT YET REC'D.

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. (B)(4).