MAUDE Adverse Event Report: HERNIAMESH SRL T-SLING; URINARY INCONTINENCE SLING

Model Number 5194001400

Device Problems Detachment Of Device Component (1104); Component Falling (1105); Material Erosion (1214); Extrusion (2934)

Patient Problem No Known Impact Or Consequence To Patient (2692)

Event Date 04/22/2014

Event Type  Injury  

Manufacturer Narrative

Not returned.

Event Description

Plaintiff implanted with t-sling (b)(4) on (b)(6) 2014.Mesh removal occurred on (b)(6) 2014.See (b)(4).Patient's legal representative stated voiding dysfunction, erosion, extrusion, dyspareunia, she will occasionally have mesh appear in her underwear x5, afraid to have intercourse due to the fact that her doctor told her the mesh needed to be cut and could not guarantee that it would hold together.

• Brand Name: T-SLING
• Type of Device: URINARY INCONTINENCE SLING
• Manufacturer (Section D): HERNIAMESH SRL; via fratelli meliga 1/c; chivasso, torino 10034 ; IT 10034
• Manufacturer (Section G): HERNIAMESH SRL; via fratelli meliga 1/c; chivasso, torino 10034 ; IT 10034
• Manufacturer Contact: selanna martorana ; via fratelli meliga 1/c; chivasso, torino 10034 ; IT 10034 ; 9011919623
• MDR Report Key: 6095339
• MDR Text Key: 59744963
• Report Number: 9614846-2016-00216
• Device Sequence Number: 1
• Product Code: PAH
• UDI-Device Identifier: 28032919892120
• UDI-Public: 28032919892120
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: distributor
• Type of Report: Initial
• Report Date: 11/10/2016

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?: Yes
• Device Operator: No Information
• Device Expiration Date: 10/31/2017
• Device Model Number: 5194001400
• Device Lot Number: 0893
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 10/12/2016
• Initial Date FDA Received: 11/11/2016
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 11/20/2012
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Outcome(s): Congenital Anomaly; Hospitalization; Required Intervention; Disability