FDA Adverse Event Other Summary report: N

ESSURE

MDR report key: 1353988 · Received March 31, 2009

Report

Report Number
2951250-2009-00013
Event Type
Other
Date Received
March 31, 2009
Date of Event
February 20, 2009
Report Date
January 19, 2017
Manufacturer
BAYER PHARMA AG
Product Code
HHS
PMA / PMN Number
P020014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

ECTOPIC PREGNANCY. PHYSICIAN REPORTED PT WITH ECTOPIC PREGNANCY (DATE OF REPORTED PREGNANCY (B) (6) 2008) 14 MONTHS FOLLOWING THE ESSURE PROCEDURE (DATE OF PROCEDURE (B) (6) 2007). HSG ((B) (6) 2008) REPORTED THAT MICRO-INSERTS APPEARED PROPERLY PLACED AND THAT OCCLUSION WAS DEMONSTRATED. CONCEPTUS HAS NOT REVIEWED HSG FILMS. THE PREGNANCY WAS DISCONTINUED IN (B) (6) 2008 AND A HYSTERECTOMY WAS PERFORMED ON (B) (6) 2009. DURING THE HYSTERECTOMY, IT WAS NOTED THAT THE MICRO-INSERT WAS NO LONGER IN THE PROPER LOCATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ESSURE INSERT, TUBAL OCCLUSION HHS BAYER PHARMA AG ESS305 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention