MAUDE Adverse Event Report: COOK BIOTECH BIODESIGN URETHRAL SLING

Device Problem Insufficient Information (3190)

Patient Problems Pain (1994); Injury (2348)

Event Type  Injury  

Event Description

The pt was reported implanted a boston science polyform on (b)(6) 2011, at (b)(6), by dr (b)(6).The pt was implanted with a surgisis biodesign urethral sling on (b)(6) '2011, at (b)(6), by dr (b)(6).The pt and her attorney have alleged that as a result of these products being implanted in the pt, the pt has experienced pain, injury, and had undergone medical treatment.The following info has not provided by the complainant: specific info of the alleged injury; specific info regarding whether intervention was performed; specific info regarding why intervention was performed or what type/to what extent intervention was performed; specific correlation between device performance and alleged injury; current pt status.

Manufacturer Narrative

Method: product not returned to cbi.Results: product not returned to cbi.Ec conclusions: root cause inconclusive due to lack of details provided by the complainant.Investigation - evaluation: investigation into this claim included a review of the claim allegations and all other communication and investigation into this report/ claim is being handled by our attorney.Summary of investigation findings: based on the info provided by the complaint, details regarding a specific correlation between the surgisis biodesign urethral sling's performance and the alleged injury remain unk.A root cause of the claim allegations is inconclusive due to lack of details provided by the complainant.All other matters relating to this litigation are being handled by our attorney.If/when additional info is obtained a follow-up mdr will be filed.

• Brand Name: BIODESIGN URETHRAL SLING
• Type of Device: URETHRAL SLING
• Manufacturer (Section D): COOK BIOTECH; west lafayette IN 47906
• Manufacturer Contact: perry guinn, vp ; 1425 innovation place; west lafayette, IN 47906 ; 7654973355
• MDR Report Key: 4530898
• MDR Text Key: 16176890
• Report Number: 1835959-2015-00032
• Device Sequence Number: 1
• Product Code: PAG
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K992159
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 02/12/2015

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 01/23/2015
• Initial Date FDA Received: 02/13/2015
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Treatment: BOSTON SCIENTIFIC POLYFORM
• Patient Outcome(s): Disability