FDA Adverse Event Malfunction Summary report: N

PROLIEVE THERMODILITATION KIT

MDR report key: 1172916 · Received September 19, 2008

Report

Report Number
3005099803-2008-04725
Event Type
Malfunction
Date Received
September 19, 2008
Date of Event
June 18, 2008
Report Date
August 20, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MEQ
PMA / PMN Number
P030006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE LOT NUMBER OF THE PROLIEVE THERMODILITATION KIT IS NOT KNOWN; THEREFORE, THE DEVICE MANUFACTURE DATE AND EXPIRATION DATE CANNOT BE DETERMINED. 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

IN 2008, IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A PROLIEVE THERMODILITATION KIT WAS USED DURING A BENIGN PROSTATIC HYPERPLASIA (BPH) PROCEDURE ON TWO DAYS EARLIER. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE UPON INSERTION, THE PHYSICIAN COULD NOT PLACE THE CATHETER DUE TO A PROBLEM WITH THE TIP. THE PHYSICIAN BELIEVES THE TIP BUCKLED AND WAS LIKELY DUE TO A URETHRAL STRICTURE. THE PROCEDURE WAS COMPLETED WITH ANOTHER PROLIEVE THERMODILITATION KIT. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT. 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