FDA Adverse Event Injury Summary report: N

ESSURE

MDR report key: 16996935 · Received May 24, 2023

Report

Report Number
2951250-2023-02450
Event Type
Injury
Date Received
May 24, 2023
Date of Event
May 10, 2011
Report Date
November 30, 2023
Manufacturer
BAYER PHARMA AG
Product Code
HHS
UDI-DI
10888853003051
PMA / PMN Number
P020014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THIS SPONTANEOUS CASE WAS ORIGINALLY REPORTED BY A LAWYER ON BEHALF OF A CONSUMER AND DESCRIBES THE OCCURRENCE OF MEDICAL DEVICE REMOVAL ("ESSURE REMOVAL") IN A 23 YEAR-OLD FEMALE PATIENT WHO HAD ESSURE INSERTED (LOT NO. 828206) FOR FEMALE STERILISATION. THE PATIENT HAD A MEDICAL HISTORY OF DYSPAREUNIA, PELVIC PAIN, ABORTION, BREAST TENDERNESS, ABDOMINAL BLOATING, IRREGULAR MENSTRUAL CYCLE, PARITY 2 AND MULTI GRAVIDA. ON (B)(6) 2009, THE PATIENT HAD ESSURE INSERTED. ON (B)(6) 2011, 781 DAYS AFTER ESSURE INSERTION, SHE UNDERWENT MEDICAL DEVICE REMOVAL (SERIOUSNESS CRITERION INTERVENTION REQUIRED). ESSURE WAS REMOVED ON (B)(6) 2014. THE PATIENT WAS TREATED WITH SURGERY (BILATERAL PARTIAL SALPINGECTOMIES). THE REPORTER CONSIDERED MEDICAL DEVICE REMOVAL TO BE RELATED TO ESSURE ADMINISTRATION. THE REPORTER COMMENTED: DISCREPANCY NOTED - PREVIOUSLY THE DATE OF REMOVAL WAS (B)(6) 2014 AND AS PER MEDICAL RECORD THE DATE OF ESSURE REMOVAL WAS (B)(6) 2011. DIAGNOSTIC RESULTS (NORMAL RANGES ARE PROVIDED IN PARENTHESIS IF AVAILABLE): [PATHOLOGY TEST] ON (B)(6) 2011: FINAL DIAGNOSIS: FALLOPIAN TUBES. BILATERAL PARTIAL SALPINGECTOMIES, COMPLETE CROSS-SECTIONS OF FALLOPIAN TUBES IDENTIFIED SPECIMEN: BILATERAL FALLOPIAN TUBES AND ESSURE COILS. CLINICAL HISTORY/DIAGNOSES: PELVIC PAIN, DYSPAREUNIA THE MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES DATA RECEIVED ON: 10-NOV-2023: REPORTERS,MEDICAL HIATORY,LAB DATA,LOT NO.,INSERTION DATE,NON DRUG TREATMENT ADDED. WE RECEIVED A LOT NUMBER IN THIS CASE. A TECHNICAL INVESTIGATION WILL BE CONDUCTED, INCLUDING A BATCH REVIEW, AND A REVIEW OF COMPLAINT RECORDS AND OTHER RELEVANT DATA; SHOULD ANY NEW AND REPORTABLE INFORMATION BECOME AVAILABLE FROM OUR INVESTIGATION, THIS WILL BE PROVIDED IN A SUPPLEMENTARY REPORT.

Description of Event or Problem · 0

THIS SPONTANEOUS CASE WAS ORIGINALLY REPORTED BY A LAWYER ON BEHALF OF A CONSUMER AND DESCRIBES THE OCCURRENCE OF MEDICAL DEVICE REMOVAL ("ESSURE REMOVAL") IN A 26 YEAR-OLD FEMALE PATIENT WHO HAD ESSURE INSERTED. THERE WAS NO INFORMATION ON THE PATIENT'S MEDICAL HISTORY OR CONCURRENT CONDITIONS. ON (B)(6)2009, THE PATIENT HAD ESSURE INSERTED. ON (B)(6)2014, 1887 DAYS AFTER ESSURE INSERTION, SHE UNDERWENT MEDICAL DEVICE REMOVAL (SERIOUSNESS CRITERION INTERVENTION REQUIRED). ESSURE WAS REMOVED THE SAME DAY. THE PATIENT WAS TREATED WITH SURGERY (SURGICAL REMOVAL OF COILS). THE REPORTER CONSIDERED MEDICAL DEVICE REMOVAL TO BE RELATED TO ESSURE ADMINISTRATION. QUALITY-SAFETY EVALUATION OF PTC: FOR ESSURE: NO DEFECT COULD BE CONFIRMED BY THE MANUFACTURER. ALL PRODUCT BATCHES HAVE MET THE SPECIFICATIONS REGARDING LABELING, MATERIAL, AND PROCESS CONTROLS AT TIME OF RELEASE. TREND ANALYSES OF COMPLAINTS ARE REVIEWED REGULARLY, NO SIGNAL WAS OBSERVED WITH REGARD TO THE REPORTED COMPLAINT REASON. THE RISK MANAGEMENT FILE WAS REVIEWED AND AN UPDATE WAS NOT DEEMED REQUIRED. A TECHNICAL INVESTIGATION OF THE COMPLAINT SAMPLE AND BATCH RECORD REVIEW COULD NOT BE CONDUCTED, AS NO SAMPLE OR BATCH NUMBER WERE AVAILABLE. BASED ON THE AVAILABLE INFORMATION, A REVIEW OF OUR COMPLAINT RECORDS AND OTHER RELEVANT DATA WAS CONDUCTED; ANY NEW AND REPORTABLE INFORMATION THAT BECOMES AVAILABLE FROM OUR INVESTIGATION WILL BE PROVIDED IN A SUPPLEMENTARY REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
948460 ESSURE TRANSCERVICAL CONTRACEPTIVE TUBAL OCCLUSION DEVICE HHS BAYER PHARMA AG ESS305 828206 10888853003051

Patients

Seq Age Sex Outcome Treatment
1 23 YR Female Required Intervention