FDA Adverse Event Injury Summary report: N

ESSURE

MDR report key: 7055886 · Received November 23, 2017

Report

Report Number
2951250-2017-07678
Event Type
Injury
Date Received
November 23, 2017
Report Date
August 23, 2018
Manufacturer
BAYER PHARMA AG
Product Code
HHS
PMA / PMN Number
P020014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

SPONTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF PELVIC PAIN ("PELVIC PAIN/PAIN") IN A 23-YEAR-OLD FEMALE PATIENT WHO HAD ESSURE (BATCH NO. 802745) INSERTED. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. OTHER PRODUCT OR PRODUCT USE ISSUES IDENTIFIED: DEVICE MONITORING PROCEDURE NOT PERFORMED "SHE DID NOT PERFORM ESSURE CONFIRMATION TEST.". CONCOMITANT PRODUCTS INCLUDED MEDROXYPROGESTERONE (DEPO PROVERA) (B)(6) 2011 TO (B)(6) 2011. ON (B)(6) 2011, THE PATIENT HAD ESSURE INSERTED. IN (B)(6) 2011, THE PATIENT EXPERIENCED NAUSEA ("NAUSEA"), MIGRAINE ("MIGRAINES") AND HEADACHE ("MIGRAINES / HEADACHES"). IN 2011, THE PATIENT EXPERIENCED VAGINAL HAEMORRHAGE ("ABNORMAL BLEEDING (VAGINAL, MENORRHAGIA)") AND MENORRHAGIA ("ABNORMAL BLEEDING (VAGINAL, MENORRHAGIA)"). IN 2012, THE PATIENT EXPERIENCED BACTERIAL VAGINOSIS ("INFECTION TYPE: BACTERIAL VAGINOSIS") AND DYSMENORRHOEA ("DYSMENORRHEA (CRAMPING)"). ON AN UNKNOWN DATE, THE PATIENT EXPERIENCED PELVIC PAIN (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED), ABDOMINAL DISCOMFORT ("PRESSURE"), BACK PAIN ("BACK PAIN"), WEIGHT INCREASED ("WEIGHT GAIN"), ABDOMINAL PAIN ("ABDOMINAL PAIN") AND FATIGUE ("FATIGUE"). THE PATIENT WAS TREATED WITH SURGERY (HAD SURGERY TO REMOVE THE ESSURE IMPLANT). ESSURE WAS REMOVED ON (B)(6) 2014. AT THE TIME OF THE REPORT, THE PELVIC PAIN, ABDOMINAL DISCOMFORT, BACK PAIN, BACTERIAL VAGINOSIS, VAGINAL HAEMORRHAGE, MENORRHAGIA, DYSMENORRHOEA, WEIGHT INCREASED, MIGRAINE, HEADACHE AND ABDOMINAL PAIN OUTCOME WAS UNKNOWN AND THE NAUSEA AND FATIGUE HAD RESOLVED. THE REPORTER CONSIDERED ABDOMINAL DISCOMFORT, ABDOMINAL PAIN, BACK PAIN, BACTERIAL VAGINOSIS, DYSMENORRHOEA, FATIGUE, HEADACHE, MENORRHAGIA, MIGRAINE, NAUSEA, PELVIC PAIN, VAGINAL HAEMORRHAGE AND WEIGHT INCREASED TO BE RELATED TO ESSURE. THE REPORTER COMMENTED: PATIENT NEED FOR ADDITIONAL SURGERY. QUALITY-SAFETY EVALUATION OF PTC: UNABLE TO CONFIRM COMPLAINT. MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES: ON 21-AUG-2018: QUALITY SAFETY EVALUATION OF PRODUCT TECHNICAL COMPLAINT. INCIDENT AT THE TIME OF REPORTING, THERE IS NO EVIDENCE THAT A DEVICE-RELATED DEFECT OR MALFUNCTION CAUSED A DEATH OR SERIOUS INJURY. IF ADDITIONAL INFORMATION BECOMES AVAILABLE IT WILL BE PROVIDED ON A SUPPLEMENTAL REPORT.

Additional Manufacturer Narrative · 0

NTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF PELVIC PAIN ("PELVIC PAIN/PAIN") IN A 23-YEAR-OLD FEMALE PATIENT WHO HAD ESSURE (BATCH NO. 802745) INSERTED. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. OTHER PRODUCT OR PRODUCT USE ISSUES IDENTIFIED: DEVICE MONITORING PROCEDURE NOT PERFORMED "SHE DID NOT PERFORM ESSURE CONFIRMATION TEST." CONCOMITANT PRODUCTS INCLUDED MEDROXYPROGESTERONE (DEPO PROVERA)28-JAN-2011 TO APRIL 2011. ON (B)(6) 2011, THE PATIENT HAD ESSURE INSERTED. IN (B)(6) 2011, THE PATIENT EXPERIENCED NAUSEA ("NAUSEA"), MIGRAINE ("MIGRAINES") AND HEADACHE ("MIGRAINES / HEADACHES"). IN 2011, THE PATIENT EXPERIENCED VAGINAL HAEMORRHAGE ("ABNORMAL BLEEDING (VAGINAL, MENORRHAGIA)") AND MENORRHAGIA ("ABNORMAL BLEEDING (VAGINAL, MENORRHAGIA)"). IN 2012, THE PATIENT EXPERIENCED BACTERIAL VAGINOSIS ("INFECTION TYPE: BACTERIAL VAGINOSIS") AND DYSMENORRHOEA ("DYSMENORRHEA (CRAMPING)"). ON AN UNKNOWN DATE, THE PATIENT EXPERIENCED PELVIC PAIN (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED), ABDOMINAL DISCOMFORT ("PRESSURE"), BACK PAIN ("BACK PAIN"), WEIGHT INCREASED ("WEIGHT GAIN"), ABDOMINAL PAIN ("ABDOMINAL PAIN") AND FATIGUE ("FATIGUE"). THE PATIENT WAS TREATED WITH SURGERY (HAD SURGERY TO REMOVE THE ESSURE IMPLANT). ESSURE WAS REMOVED ON (B)(6) 2014. AT THE TIME OF THE REPORT, THE PELVIC PAIN, ABDOMINAL DISCOMFORT, BACK PAIN, BACTERIAL VAGINOSIS, VAGINAL HAEMORRHAGE, MENORRHAGIA, DYSMENORRHOEA, WEIGHT INCREASED, MIGRAINE, HEADACHE AND ABDOMINAL PAIN OUTCOME WAS UNKNOWN AND THE NAUSEA AND FATIGUE HAD RESOLVED. THE REPORTER CONSIDERED ABDOMINAL DISCOMFORT, ABDOMINAL PAIN, BACK PAIN, BACTERIAL VAGINOSIS, DYSMENORRHOEA, FATIGUE, HEADACHE, MENORRHAGIA, MIGRAINE, NAUSEA, PELVIC PAIN, VAGINAL HAEMORRHAGE AND WEIGHT INCREASED TO BE RELATED TO ESSURE. THE REPORTER COMMENTED: PATIENT NEED FOR ADDITIONAL SURGERY. MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES: ON 20-JUN-2018: PLAINTIFF FACT SHEET RECEIVED. EVENTS BACTERIAL VAGINOSIS, VAGINAL, MENORRHAGIA, NAUSEA, DYSMENORRHEA, WEIGHT GAIN, , MIGRAINES, HEADACHES, DEVICE MONITORING PROCEDURE NOT PERFORMED WAS ADDED. LOT NUMBER & LAB DATA UPDATED. CONCOMITANT & HISTORICAL DRUGS , CONDITIONS WERE ADDED. PRODUCT, PATIENT & REPORTER INFORMATION UPDATED. INCIDENT: AT THE TIME OF REPORTING, THERE IS NO EVIDENCE THAT A DEVICE-RELATED DEFECT OR MALFUNCTION CAUSED A DEATH OR SERIOUS INJURY. IF ADDITIONAL INFORMATION BECOMES AVAILABLE IT WILL BE PROVIDED ON A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THIS SPONTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF PELVIC PAIN ("PELVIC PAIN/PAIN") IN A FEMALE PATIENT WHO HAD ESSURE INSERTED. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. ON (B)(6) 2011, THE PATIENT HAD ESSURE INSERTED. ON AN UNKNOWN DATE, THE PATIENT EXPERIENCED PELVIC PAIN (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED), ABDOMINAL DISCOMFORT ("PRESSURE") AND BACK PAIN ("BACK PAIN"). THE PATIENT WAS TREATED WITH SURGERY (HAD SURGERY TO REMOVE THE ESSURE IMPLANT). ESSURE WAS REMOVED ON (B)(6) 2014. AT THE TIME OF THE REPORT, THE PELVIC PAIN, ABDOMINAL DISCOMFORT AND BACK PAIN OUTCOME WAS UNKNOWN. THE REPORTER CONSIDERED ABDOMINAL DISCOMFORT, BACK PAIN AND PELVIC PAIN TO BE RELATED TO ESSURE. THE REPORTER COMMENTED: PATIENT NEED FOR ADDITIONAL SURGERY INCIDENT NO LOT NUMBER OR SAMPLE AVAILABLE FOR INVESTIGATION. THERE IS NO EVIDENCE THAT A DEVICE-RELATED DEFECT OR MALFUNCTION CAUSED A DEATH OR SERIOUS INJURY. IF ADDITIONAL INFORMATION BECOMES AVAILABLE IT WILL BE PROVIDED ON A SUPPLEMENTAL REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
835247 ESSURE TRANSCERVICAL CONTRACEPTIVE TUBAL OCCLUSION DEVICE HHS BAYER PHARMA AG ESS305 802745

Patients

Seq Age Sex Outcome Treatment
1 23 YR Other| R DEPO PROVERA| DEPO PROVERA