inforMED
InjuryPAJ

XENFORM SOFT TISSUE REPAIR MATRIX

Received Aug 15, 2018 · Event occurred Jan 28, 2015

Report 3005099803-2018-02560 · MDR key 7785092

Device

Generic name

Mesh, Surgical, Non-synthetic, Urogynecologic For Apical Vaginal And Uterine Pro

Model number

M0068302470

Lot number

0001411010

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

56 YR

  • Urinary Tract Infection
  • Urinary Tract Infection

Narrative

Additional Manufacturer Narrative

THE PATIENT¿S ID IS (B)(6). STUDY NAME: (B)(6). THE COMPLAINANT INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR INVESTIGATION. THEREFORE, A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED, A SUPPLEMENTAL MDR WILL BE FILED.

Description of Event or Problem

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A XENFORM TISSUE REPAIR MATRIX WAS USED DURING A PELVIC FLOOR RECONSTRUCTION WITH APICAL VAULT SUSPENSION AND CYSTOCELE REPAIR PROCEDURE PERFORMED ON (B)(6) 2015. ACCORDING TO THE COMPLAINANT, ON (B)(6) 2015, THE PATIENT EXPERIENCED A LOWER URINARY TRACT INFECTION AND WAS TREATED WITH AUGMENTIN. THE EVENT WAS RESOLVED ON (B)(6) 2015.