FDA Adverse Event Summary report: N

ESSURE

MDR report key: 3003707 · Received March 12, 2013

Report

Report Number
3003707
Date Received
March 12, 2013
Date of Event
March 6, 2013
Report Date
March 7, 2013
Manufacturer
CONCEPTUS INC.
Product Code
HHS
Report Source
User Facility report
Reporter Location
MI, US

Narratives

Description of Event or Problem · 1

THE ESSURE DEVICE WAS BENT AND UNABLE TO BE INSERTED INTO PATIENT'S FALLOPIAN TUBE.WHAT WAS THE ORIGINAL INTENDED PROCEDURE?HYSTEROSCOPY WITH TUBAL OCCLUSION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
103320 ESSURE DEVICE, OCCLUSION, TUBAL, CONTRACEPTIVE HHS CONCEPTUS INC. ESS305 A66680

Patients

Seq Age Sex Outcome Treatment
1 25 YR