MAUDE Adverse Event Report: Contura International A/S Bulkamid; agent, bulking, injectable for gastro-urology use

Model Number	50050
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes	Unspecified Infection (1930); Pain (1994); Discomfort (2330)
Date of Event	04/22/2026
Type of Reportable Event	Serious Injury
Event or Problem Description
It was reported that a patient who underwent bulkamid placement procedure, had developed pain in the urethra three weeks after, the physician has decided to treat him with antibiotics due to suspected infection.The issue was reported as ongoing.
Event or Problem Description
It was reported that a patient who underwent bulkamid placement procedure, had developed pain in the urethra three weeks after, the physician has decided to treat him with antibiotics due to suspected infection.The issue was reported as ongoing.
Additional Manufacturer Narrative
Correction block h6 has been corrected by removing code f1906.Detailed product information was not provided to bsc.We completed a good faith effort to obtain the information.Because the product is unknown at this time, we are unable to provide the complete unique identifier (udi) # and other product specific information.If additional details become available, a supplemental report will be submitted.Block d4:h4 the event was unable to provide the lot number of the device implanted.Therefore, there is not information related with device manufacturer day.Block h6: imdrf patient code e2330 captures the reportable event of pain.Imdrf patient code e1906 captures the reportable event of infection.Imdrf patient code e2311 captures the reportable event of discomfort.
Additional Manufacturer Narrative
Detailed product information was not provided to bsc.We completed a good faith effort to obtain the information.Because the product is unknown at this time, we are unable to provide the complete unique identifier (udi) # and other product specific information.If additional details become available, a supplemental report will be submitted.Block d4:h4 the event was unable to provide the lot number of the device implanted.Therefore, there is not information related with device manufacturer day.Block h6: imdrf patient code e2330 captures the reportable event of pain.Imdrf patient code e1906 captures the reportable event of infection.Imdrf patient code e2311 captures the reportable event of discomfort.

• Brand Name: Bulkamid
• Common Device Name: agent, bulking, injectable for gastro-urology use
• Manufacturer (Section D): Contura International A/S; sydmarken 23; soborg 2860 ; DA 2860
• Manufacturer (Section G): Contura International A/S; sydmarken 23; soeborg 2860 ; DA 2860
• Manufacturer Contact: farshad fahimi ; 4100 hamline avenue north; building c; saint paul, MN 55112
• MDR Report Key: 50354615
• Report Number: 2124215-2026-44968
• Device Sequence Number: 12271902
• Product Code: LNM
• UDI-Device Identifier: 10810005340509
• UDI-Public: (01)10810005340509
• Combination Product (Y/N): N
• Initial Reporter State: PA
• Initial Reporter Country: US
• PMA/510(K) Number: P170023
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 09/11/2026

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 Model Number: 50050
• Device Catalogue Number: 50050
• 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: Not provided
• Supplement Date Received by Manufacturer: 08/24/2026
• Initial Report FDA Received Date: 08/20/2026
• Supplement Report FDA Received Date: 09/11/2026
• 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: Unknown