FDA Adverse Event
Other
Summary report: N
COAXESS UTERINE CATHETER
MDR report key: 44605
·
Received September 23, 1996
Report
- Report Number
- 2951250-1996-00001
- Event Type
- Other
- Date Received
- September 23, 1996
- Date of Event
- August 23, 1996
- Report Date
- September 23, 1996
- Manufacturer
- CONCEPTUS , INC.
- Product Code
- HGS
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- PHYSICIAN
Narratives
Description of Event or Problem · 1
CATHETER PERFORATED PROXIMAL SECTION OF THE FALLOPIAN TUBE DURING A FALLOPOSCOPY PROCEDURE. THIS IS AN ANTICIPATED ADVERSE EVENT AS INDICATED IN THE PRODUCT LABELING. THE ADVERSE EVENT IS MARKED "OTHER" BECAUSE IT IS UNKNOWN AS TO WHETHER THE ADVERSE EVENT RESULTS IN PERMANENT IMPAIRMENT OF BODY FUNCTION OR PERMANENT DAMAGE TO BODY STRUCTURE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | COAXESS UTERINE CATHETER | INTRAUTERINE CATHETER | HGS | CONCEPTUS , INC. | SLU-003 | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Other | LAPAROSCOPY & HYSTEROSCOPY SIMULTANEOUS |