FDA Adverse Event Injury Summary report: N

PROLIEVE THERMODILATATION KIT

MDR report key: 1080767 · Received July 23, 2008

Report

Report Number
3005099803-2008-01259
Event Type
Injury
Date Received
July 23, 2008
Report Date
June 23, 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
OTHER

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

ON JUNE 23, 2008, IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A MALE PATIENT UNDERWENT TREATMENT FOR BENIGN PROSTATIC HYPERPLASIA (BPH) WITH A PROLIEVE THERMODILATATION KIT IN 2007. ACCORDING TO THE COMPLAINANT, THE PATIENT'S WIFE STATED THAT DURING THE PROCEDURE THE PROLIEVE CATHETER CUT THE PATIENT'S URETHRA. REPORTEDLY, THE PHYSICIAN ABORTED THE CASE. THE PATIENT'S CONDITION IS UNKNOWN. A REQUEST FOR ADDITIONAL INFORMATION WAS SENT.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 UNK Other