FDA Adverse Event Malfunction Summary report: N

PROLIEVE THERMODILITATION KIT

MDR report key: 1161369 · Received September 12, 2008

Report

Report Number
3005099803-2008-04540
Event Type
Malfunction
Date Received
September 12, 2008
Date of Event
August 14, 2008
Report Date
August 14, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MEQ
PMA / PMN Number
P030006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED, BUT AN EVALUATION HAS NOT BEEN PERFORMED. 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. A PRODUCT EVALUATION IS PENDING; RESULTS WILL BE PROVIDED IN A FOLLOW-UP MEDWATCH REPORT.

Description of Event or Problem · 1

A PROLIEVE THERMODILITATION KIT WAS USED DURING A BENIGN PROSTATIC HYPERPLASIA (BPH) PROCEDURE IN 2008. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE, THE SYSTEM CONTINUED TO GIVE "LOW-WATER LEVEL" ERROR MESSAGE. THE PROLIEVE CATHETER LEAKED WATER AND THE TECH CONTINUED TO ADD WATER TO THE CARTRIDGE TO COMPLETE THE CASE. THE CASE ENDED AT 30 MINS BECAUSE THE PT WAS UNCOMFORTABLE. THE PT'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 0000607024

Patients

Seq Age Sex Outcome Treatment
1 UNK