FDA Adverse Event Malfunction Summary report: N

PROLIEVE TEMPERATURE MONITOR

MDR report key: 1171418 · Received September 17, 2008

Report

Report Number
3005099803-2008-04654
Event Type
Malfunction
Date Received
September 17, 2008
Date of Event
August 14, 2008
Report Date
August 18, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MEQ
PMA / PMN Number
P030006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE SERIAL NUMBER PROVIDED BY THE END USER COULD NOT BE CONFIRMED; THEREFORE, THE DEVICE MANUFACTURE DATE AND EXPIRATION DATE CANNOT BE DETERMINED. THE DEVICE HAS NOT BEEN RETURNED; 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 AUGUST 18, 2008, IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A PROLIEVE THERMODILITATION RECTAL TEMPERATURE MONITOR (RTM) WAS USED DURING A BENIGN PROSTATIC HYPERPLASIA (BPH) PROCEDURE IN 2008. ACCORDING TO THE COMPLAINANT, THE RTM READING WAS NOT CORRECT. THE PATIENT CONDITION IS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROLIEVE TEMPERATURE MONITOR MEQ BOSTON SCIENTIFIC CORPORATION M0068808030 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK