FDA Adverse Event Malfunction Summary report: N

PROLIEVE TEMPERATURE MONITOR

MDR report key: 1191202 · Received September 26, 2008

Report

Report Number
3005099803-2008-04894
Event Type
Malfunction
Date Received
September 26, 2008
Date of Event
August 28, 2008
Report Date
August 28, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
MEQ
PMA / PMN Number
P030006
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED, BUT AN EVALUATION HAS NOT YET 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 THERMODILATATION RECTAL TEMPERATURE MONITOR (RTM) WAS USED DURING A BENIGN PROSTATIC HYPERPLASIA (BPH) PROCEDURE IN 2008. ACCORDING TO THE COMPLAINANT, DURING THE PROCEDURE, ONE OF THE SENSORS MALFUNCTIONED; WHILE THE OTHER SENSOR REMAINED AT THE PROPER HEATING DEGREE. THE PROLIEVE RTM WAS REPLACED AND ANOTHER PROLIEVE RTM WAS USED TO COMPLETE THE PROCEDURE. NO PT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT. THE PT'S CONDITION WAS REPORTED AS "FINE."

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