AMS 700 72401850

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-10-21 for AMS 700 72401850 manufactured by American Medical Systems, Llc.

Event Text Entries

[58066408]
Patient Sequence No: 1, Text Type: N, H10


[58066409] Operative report indicates "corporal weakness at the left base of ipp" manufacturer response for accessory penile ams 700, ams 700 (per site reporter): mfg's rep picked up device for inspection.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number6046239
MDR Report Key6046239
Date Received2016-10-21
Date of Report2016-10-14
Date of Event2012-10-11
Report Date2016-10-14
Date Reported to FDA2016-10-14
Date Reported to Mfgr2016-10-14
Date Added to Maude2016-10-21
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameAMS 700
Generic NamePROSTHESIS, PENIS, INFLATABLE
Product CodeJCW
Date Received2016-10-21
Returned To Mfg2016-10-12
Catalog Number72401850
Device AvailabilityR
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerAMERICAN MEDICAL SYSTEMS, LLC
Manufacturer Address10700 BREN ROAD WEST MINNETONKA MN 55343 US 55343


Patients

Patient NumberTreatmentOutcomeDate
10 2016-10-21

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