FDA Adverse Event Malfunction Summary report: N

PROLIEVE THERMODILITATION SYSTEM

MDR report key: 1171466 · Received September 17, 2008

Report

Report Number
3005099803-2008-04665
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
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

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

IN 2008, IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A PROLIEVE THERMODILITATION SYSTEM WAS USED DURING A BENIGN PROSTATIC HYPERPLASIA (BPH) PROCEDURE FOUR DAYS PRIOR. ACCORDING TO THE COMPLAINANT, DURING PREPARATION OF THE RTM (RECTAL TEMPERATURE MONITOR) SENSOR NUMBER THREE WAS TWELVE DEGREES HIGHER THAN THE REST. THE PROCEDURE WAS NOT PERFORMED DUE TO THIS ISSUE. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROLIEVE THERMODILITATION SYSTEM MEQ BOSTON SCIENTIFIC CORPORATION M0068808000 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK