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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COLOPLAST A/S TITAN; INFLATABLE PENILE PROSTHESIS

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COLOPLAST A/S TITAN; INFLATABLE PENILE PROSTHESIS Back to Search Results
Model Number EN88162400
Device Problems Positioning Problem (3009); Insufficient Information (3190)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/26/2021
Event Type  Injury  
Manufacturer Narrative
Without the benefit of examination and testing, coloplast is precluded from commenting on the condition of the device or the cause of the occurrence.Should additional facts prompt us to alter or supplement any information or conclusions contained in the original mdr or in any prior supplemental reports, a follow-up report will be submitted.The lot number (6050537) was reviewed for complaint trend, nonconforming report and capa.Devices met specification prior to release and no trends were noted.
 
Event Description
According to available information, this device was explanted and replaced due to patient requesting longer/larger cylinders as well as an unspecified malfunction and poor pump positioning.No other adverse patient effects were reported.
 
Manufacturer Narrative
Titan pump, cylinders 1 and 2, and detached connector / inlet tubing were received for evaluation.No functional abnormalities were noted with the pump.No functional abnormalities were noted with neither cylinder 1 nor cylinder 2.No functional abnormalities were noted with the detached connector or inlet tubing.The information received indicated that the patient wanted a different implant size, and the device was in poor position, but because no functional abnormalities were noted with the returned components, the complaint could not be confirmed as reported.A review of the device history record confirmed the devices from this lot met all specifications prior to release.A review of the complaint history database, nonconformances and capas revealed no trends for this lot.
 
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Brand Name
TITAN
Type of Device
INFLATABLE PENILE PROSTHESIS
Manufacturer (Section D)
COLOPLAST A/S
holtedam 1
humlebæk 3050
DA  3050
Manufacturer (Section G)
COLOPLAST MANUFACTURING US, LLC
1601 west river road north
minneapolis MN 55411
Manufacturer Contact
usaby angela kilian
1601 west river road north
minneapolis, MN 55411
8007880293
MDR Report Key14103541
MDR Text Key289196381
Report Number2125050-2022-00381
Device Sequence Number1
Product Code FHW
UDI-Device Identifier05708932072595
UDI-Public05708932072595
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P000006
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 07/28/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/13/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Lay User/Patient
Device Expiration Date01/11/2023
Device Model NumberEN88162400
Device Catalogue NumberEN8816
Device Lot Number6050537
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/06/2022
Is the Reporter a Health Professional? Yes
Date Manufacturer Received06/29/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/14/2018
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age62 YR
Patient SexMale
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