MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2020-02-11 for AMS ADVANCE XP SLING SYSTEM 720163-02 manufactured by Boston Scientific Corporation.
[178637578]
It was reported that the arms on the advance xp sling device would not clip to the trocar/needle passer. The sling was exchanged for another and worked sufficiently. A patient outcome of no further complications was reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2183959-2020-00616 |
| MDR Report Key | 9695411 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL |
| Date Received | 2020-02-11 |
| Date of Report | 2020-03-16 |
| Date of Event | 2020-01-20 |
| Date Mfgr Received | 2020-02-22 |
| Device Manufacturer Date | 2019-08-05 |
| Date Added to Maude | 2020-02-11 |
| 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 | 3 |
| Event Location | 3 |
| Manufacturer Contact | ALYSON HARRIS |
| Manufacturer Street | 10700 BREN ROAD W |
| Manufacturer City | MINNETONKA MN 55343 |
| Manufacturer Country | US |
| Manufacturer Postal | 55343 |
| Manufacturer Phone | 4089353452 |
| Manufacturer G1 | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Street | 780 BROOKSIDE DRIVE |
| Manufacturer City | SPENCER IN 47460 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 47460 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | AMS ADVANCE XP SLING SYSTEM |
| Generic Name | MESH SURGICAL FOR STRESS URINARY INCONTINENCE MALE |
| Product Code | OTM |
| Date Received | 2020-02-11 |
| Returned To Mfg | 2020-02-25 |
| Model Number | 720163-02 |
| Catalog Number | 720163-02 |
| Lot Number | 0024612065 |
| Operator | LAY USER/PATIENT |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Address | 100 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 017521242 US 017521242 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-02-11 |