MAUDE Adverse Event Report: CALDERA MEDICAL INC. GYNECARE TVTTM RETROPUBIC SYSTEM, BLUE LASER CUT MESH; TVT-CAL-RETROPUBIC

Model Number	830041BL
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Erosion (1750); Pain (1994); Dyspareunia (4505); Genital Bleeding (4507)
Date of Event	10/15/2025
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
The product was not returned.Based on the available information, it has been determined that no corrective or preventive action will be proposed at this time.This complaint will be documented and monitored through post-market surveillance activities.If additional information becomes available, the investigation will be updated as necessary.The manufacturing number is (b)(4).
Event or Problem Description
The mhra health authority reported the following: there has been ongoing dyspareunia (painful intercourse) and vaginal bleeding for the past two years.A 0.5 cm area of mesh extrusion has been observed at the mid-urethra, located just to the left of the midline.This case should be discussed at the mdt (multidisciplinary team meeting), and a referral to a specialized mesh center is recommended.The availability of the device is currently unknown.Mhra reference number: (b)(4).
Additional Manufacturer Narrative
Additional information: d4, d5, e3, h4, h6 , h11.Investigation results: an analysis of the product could not be performed since a physical sample was not received for evaluation."a manufacturing record evaluation was performed for the finished lot number 3474132 (product code 830041bl), and no non-conformances / manufacturing irregularities were identified.Expiration date: 31.Oct.2013 manufacturing date: 26.Oct.2010" as part of our company quality system process, all devices are manufactured, inspected, and distributed to approved specifications.Based on the information available, there is no indication that a design or manufacturing issue has caused the reported complaint condition; therefore, it has been determined that no corrective and preventive action is required at this time.Additional complaint information monitoring for potential safety signals will be conducted through complaint trending as part of the post-market surveillance.However, if the product is received at a later date, the investigation will be updated as applicable the manufacturing number is: (b)(4).

• Brand Name: GYNECARE TVTTM RETROPUBIC SYSTEM, BLUE LASER CUT MESH
• Common Device Name: TVT-CAL-RETROPUBIC
• Manufacturer (Section D): CALDERA MEDICAL INC.; 4360 park terrace dr.; suite 140; westlake village CA 91361
• Manufacturer (Section G): CALDER MEDICAL SARL-NAUCHATEL; puits-godet 20; neuchatel, 2000 ; WZ 2000
• Manufacturer Contact: mahtab moberg ; 4360 park terrace dr. suite 140; westlake village, CA 91361
• MDR Report Key: 23482707
• Report Number: 3003990090-2025-01718
• Device Sequence Number: 9496351
• Product Code: OTN
• UDI-Device Identifier: 10705031062290
• UDI-Public: 10705031062290
• Combination Product (Y/N): N
• Initial Reporter Country: UK
• PMA/510(K) Number: K033568
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 01/27/2026

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
• Operator of Device: Health Professional
• Device Expiration Date: 10/31/2013
• Device Model Number: 830041BL
• Device Lot Number: 3474132
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 10/29/2025
• Supplement Date Received by Manufacturer: 11/13/2026
• Initial Report FDA Received Date: 11/05/2025
• Supplement Report FDA Received Date: 01/27/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 10/26/2010
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Sex: Female