FDA Adverse Event Malfunction Summary report: N

SOLYX SIS SYSTEM

MDR report key: 3024184 · Received March 27, 2013

Report

Report Number
3005099803-2013-02286
Event Type
Malfunction
Date Received
March 27, 2013
Report Date
March 1, 2013
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K081275
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF THE MANUFACTURING RECORDS FOR THIS LOT SHOWED NO EVIDENCE OF A MANUFACTURING-RELATED POTENTIAL CAUSE FOR THIS EVENT. VISUAL ANALYSIS OF THE RETURNED SOLYX SIS SYSTEM SHOWED THAT THE MESH IS STRETCHED AND FRAYED AT ONE END, APPROXIMATELY 2 CM FROM THE CARRIER. SINCE THE INVESTIGATION REVEALED THAT THE DAMAGE TO THE MESH OCCURRED AT THE END NEAR THE CARRIER AND NOT AT THE CENTRAL PORTION, THIS EVENT IS NO LONGER CONSIDERED REPORTABLE.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT THE DURING A PROCEDURE USING A SOLYX SINGLE INCISION SLING SYSTEM, AS THE PHYSICIAN WENT TO PLACE THE SECOND SIDE, HE NOTICED THAT THE MESH WAS STRETCHED (SPECIFICS UNKNOWN). THE PHYSICIAN REMOVED THE DEVICE FROM THE PATIENT AND COMPLETED THE PROCEDURE WITH ANOTHER SOLYX DEVICE. THERE WERE NO COMPLICATIONS TO THE PATIENT, WHO WAS FINE AT THE CONCLUSION OF THE PROCEDURE.

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT THE DURING A PROCEDURE USING A SOLYX SINGLE INCISION SLING SYSTEM, AS THE PHYSICIAN WENT TO PLACE THE SECOND SIDE, HE NOTICED THAT THE MESH WAS STRETCHED (SPECIFICS UNKNOWN). THE PHYSICIAN REMOVED THE DEVICE FROM THE PATIENT AND COMPLETED THE PROCEDURE WITH ANOTHER SOLYX DEVICE. THERE WERE NO COMPLICATIONS TO THE PATIENT, WHO WAS FINE AT THE CONCLUSION OF THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
125806 SOLYX SIS SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH M0068507000 ML00000925

Patients

Seq Age Sex Outcome Treatment
1