FDA Adverse Event Injury Summary report: N

ADVANTAGE FIT SYSTEM

MDR report key: 3173882 · Received June 17, 2013

Report

Report Number
3005099803-2013-05230
Event Type
Injury
Date Received
June 17, 2013
Date of Event
April 18, 2013
Report Date
May 23, 2013
Manufacturer
BOSTON SCIENTIFIC - MARLBOROUGH
Product Code
FTL
PMA / PMN Number
K020110
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN ADVANTAGE FIT SYSTEM WAS IMPLANTED ON (B)(6) 2013. THAT NIGHT, VASOPRESSOR WAS GIVEN TO THE PATIENT FOR LOWERED BLOOD PRESSURE. ADDITIONALLY, AT SOME POINT AFTER THE PROCEDURE THE PATIENT EXPERIENCED URINE LEAKAGE. ON (B)(6) 2013 A CT SCAN REVEALED A LARGE HEMATOMA ON THE RIGHT SIDE OF THE PELVIS. THE PHYSICIAN OPINES THAT THE DROP IN BLOOD PRESSURE WAS CAUSED BY THE HEMATOMA, WHICH MAY HAVE BEEN CAUSED WHEN HE PLACED THE RIGHT SIDE NEEDLE TIP SLIGHTLY MORE LATERALLY THAN USUAL. REPORTEDLY, THE BLADDER BECAME DEFORMED AS A RESULT OF COMPRESSION BY THE HEMATOMA. REPORTEDLY, THE PATIENT¿S BLOOD PRESSURE HAS SINCE RISEN, AND THE PHYSICIAN IS TAKING A WAIT-AND-SEE APPROACH WITH CONSERVATIVE THERAPY (SPECIFICS UNKNOWN). NO FURTHER INFORMATION IS AVAILABLE, THE PATIENT IS CURRENTLY BEING MONITORED. IF ADDITIONAL RELEVANT INFORMATION IS OBTAINED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
273633 ADVANTAGE FIT SYSTEM MESH, SURGICAL, POLYMERIC FTL BOSTON SCIENTIFIC - MARLBOROUGH M0068502110

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention