FDA Adverse Event Injury Summary report: N

WALLFLEX ENTERAL DUODENAL STENT

MDR report key: 1328268 · Received February 27, 2009

Report

Report Number
3005099803-2009-00882
Event Type
Injury
Date Received
February 27, 2009
Report Date
January 30, 2009
Manufacturer
BOSTON SCIENTIFIC IRELAND, LTD.
Product Code
MUM
PMA / PMN Number
K062750
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE MANUFACTURE DATE AND EXPIRATION DATE ARE UNK SINCE THE LOT # IS UNK. THE DEVICE IS NOT AVAILABLE. A DEVICE ANALYSIS CANNOT BE PERFORMED; THEREFORE, THE CAUSE OF THE REPORTED EVENT IS UNDETERMINED.

Description of Event or Problem · 1

NOTE: DATE OF EVENT IS UNK. ON JANUARY 30, 2009, A BOSTON SCIENTIFIC EMPLOYEE BECAME AWARE OF A CLINICAL STUDY ARTICLE, "COMBINED ENDOSCOPIC STENT INSERTION IN MALIGNANT BILIARY AND DUODENAL OBSTRUCTION", BY M. MUTIGNANI, ET AL. ACCORDING TO THE ARTICLE, THE WALLFLEX ENTERAL DUODENAL STENT WAS USED IN A COMBINED ENDOSCOPIC STENT INSERTION. WITHIN SEVEN DAYS OF STENT INSERTION, THE PT EXPERIENCED ACUTE PANCREATITIS AFTER INSERTION OF A BILIARY STENT. THERE IS NO FURTHER INFO FROM THE ARTICLE REGARDING THE STATUS OF THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 WALLFLEX ENTERAL DUODENAL STENT MUM BOSTON SCIENTIFIC IRELAND, LTD. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other