FDA Adverse Event Injury Summary report: N

PROLIEVE THERMODILITATION KIT

MDR report key: 1062912 · Received June 19, 2008

Report

Report Number
3005099803-2008-00796
Event Type
Injury
Date Received
June 19, 2008
Report Date
May 20, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MEQ
PMA / PMN Number
P030006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINANT INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE, A FAILURE ANALYSIS IS NOT AVAILABLE AND WE ARE NOT ABLE TO DETERMINE THE RELATIONSHIP BETWEEN THIS DEVICE AND THE CAUSE FOR THIS EVENT.

Description of Event or Problem · 1

NOTE: DATE OF EVENT IS UNK. IN 2008, IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION, THAT A PROCEDURE USING A PROLIEVE THERMODILITATION KIT TO TREAT BENIGN PROSTATIC HYPERPLASIA (BPH) OCCURRED ON A MALE PATIENT. ACCORDING TO THE COMPLAINANT, THE RECTAL TEMPERATURE MONITOR (RTM) WAS PLACED CORRECTLY, HOWEVER, DURING THE PROCEDURE, THE PATIENT COMPLAINED OF EXTREME RECTAL PAIN. THE PAIN WAS NOT THERMAL BUT DESCRIBED AS "DISCOMFORT". THE PROCEDURE WAS ABORTED AND ONCE THE RTM WAS REMOVED, THE PATIENT HAD "INSTANT RELIEF". THE PATIENT SENT HOME WITH A FOLEY CATHETER (UNKNOWN MANUFACTURER). ACCORDING TO THE COMPLAINANT, THE PATIENT DID NOT SUFFER ANY BURNS. REPORTEDLY, THE FOLEY CATHETER WAS REMOVED DURING THE FOLLOW-UP VISIT (DATE UNK) AND THE PATIENT'S CONDITION WAS REPORTED AS "FINE".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROLIEVE THERMODILITATION KIT MEQ BOSTON SCIENTIFIC CORPORATION M0068808022 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other