FDA Adverse Event Injury Summary report: N

ESSURE

MDR report key: 10371607 · Received August 6, 2020

Report

Report Number
2951250-2020-12788
Event Type
Injury
Date Received
August 6, 2020
Report Date
August 6, 2020
Manufacturer
BAYER PHARMA AG
Product Code
HHS
UDI-DI
10888853003051
PMA / PMN Number
P020014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THIS SPONTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF PELVIC PAIN ('PAIN') IN AN ADULT FEMALE PATIENT WHO HAD ESSURE (ESS205) INSERTED FOR FEMALE STERILISATION. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. THE PATIENT'S MEDICAL HISTORY INCLUDED DIABETES MELLITUS, HYPERTENSION, IODINE ALLERGY, DEPRESSION, FATIGUE, UTERINE BLEEDING AND PELVIC PAIN. IN 2003, THE PATIENT HAD ESSURE (ESS205) INSERTED. ON AN UNKNOWN DATE, THE PATIENT EXPERIENCED PELVIC PAIN (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED), GENITAL HAEMORRHAGE ("BLEEDING"), ALLERGY TO METALS ("NICKEL SENSITIVITY"), ALOPECIA ("HAIR LOSS"), DEPRESSION ("DEPRESSION"), ANAEMIA ("ANEMIA"), MENORRHAGIA ("MENORRHAGIA") AND PERIHEPATITIS ("FITZ-HUGH CURTIS SYNDROME (PERIHEPATITIS)"). THE PATIENT WAS TREATED WITH SURGERY (LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY). AT THE TIME OF THE REPORT, THE PELVIC PAIN, GENITAL HAEMORRHAGE, ALLERGY TO METALS, ALOPECIA, DEPRESSION, ANAEMIA, MENORRHAGIA AND PERIHEPATITIS OUTCOME WAS UNKNOWN. THE REPORTER CONSIDERED ALLERGY TO METALS, ALOPECIA, ANAEMIA, DEPRESSION, GENITAL HAEMORRHAGE, MENORRHAGIA, PELVIC PAIN AND PERIHEPATITIS TO BE RELATED TO ESSURE (ESS205). QUALITY-SAFETY EVALUATION OF PTC: UNABLE TO CONFIRM COMPLAINT. MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES: ON 14-JUL-2020: MR RECEIVED: CASE WAS UPGRADED TO INCIDENT. ESSURE REMOVAL DATE , EVENT MENORRHAGIA , PER HEPATITIS , MENORRHAGIA AND ANEMIA ADDED, MEDICAL HISTORY ADDED. BASED ON THE AVAILABLE INFORMATION, A REVIEW OF OUR COMPLAINT RECORDS AND OTHER RELEVANT DATA WAS CONDUCTED; ANY NEW AND REPORTABLE INFORMATION THAT BECOMES AVAILABLE FROM OUR INVESTIGATION WILL BE PROVIDED IN A SUPPLEMENTARY REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
837951 ESSURE TRANSCERVICAL CONTRACEPTIVE TUBAL OCCLUSION DEVICE HHS BAYER PHARMA AG ESS205 10888853003051

Patients

Seq Age Sex Outcome Treatment
1 Other| R