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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. TENSION FREE VAGINAL TAPE UNKNOWN PRODUCT; MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC

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ETHICON INC. TENSION FREE VAGINAL TAPE UNKNOWN PRODUCT; MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC Back to Search Results
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Pain (1994); Urinary Tract Infection (2120); Abnormal Vaginal Discharge (2123)
Event Date 10/20/2020
Event Type  Injury  
Manufacturer Narrative
(b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by ethicon inc, or its employees that the report constitutes an admission that the product, ethicon inc, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.To date it has been reported that the device will not be returned.If the device or further details are received at a later date a supplemental medwatch will be sent.H6 component code: g07002 ¿ device not returned.
 
Event Description
It was reported that a patient underwent a sling procedure on an unknown date and mesh was implanted.The patient reported experiencing a couple of urinary tract infections since implantation.In (b)(6) 2023, the patient experienced a severe urinary tract infection as well kidney stones which resulted in hospitalization and cystoscopy surgery.Post cystoscopy, the patient was told to have the stent in-situ for at least 3 weeks, but immediately after the surgery, the patient experienced a lot of pain in the pelvic region which resulted in the stent having to be removed 6 days post op.In addition to the uti¿s and cystoscopy, the patient experienced severe pain when having a urinary catheter inserted for post op surgeries.This pain was so severe that the clinicians had to remove the catheter pre timeframe.Since mesh insertion, the patient also experienced white vaginal discharge daily.No further information is available as reporter details have not been disclosed (confidential).
 
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Brand Name
TENSION FREE VAGINAL TAPE UNKNOWN PRODUCT
Type of Device
MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON SARL-NEUCHATEL
puits-godet 20
neuchatel 2000
SZ   2000
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key18622603
MDR Text Key334321569
Report Number2210968-2024-00864
Device Sequence Number1
Product Code OTN
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K974098
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Consumer
Reporter Occupation Other
Type of Report Initial
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
Initial Date Manufacturer Received 01/22/2024
Initial Date FDA Received02/01/2024
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
Removal/Correction NumberN/A
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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