MAUDE MDR 497235

MDR report key
497235
Report number
497235
Event key
0
Event type
3
Date of event
2003-11-12
Date received
2003-11-20
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#

Report source
U
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1VOLLRATHMALE URINALMEDEGEN MEDICAL PRODUCTSFNPH140D-01UNKUNKNY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12003-11-2001. O

Event Narratives#

D

Patient 1

PT'S SPOUSE TOLD THE NURSING STAFF THAT WHEN PT USED THE URINAL, IT CUT THEM. BLOODY DRAINAGE NOTED AT BASE OF PENIS AND FORESKIN AREAS. COLD PACKS APPLIED IMMEDIATELY.