FDA Adverse Event Injury Summary report: N

ESSURE

MDR report key: 9160750 · Received October 7, 2019

Report

Report Number
2951250-2019-09694
Event Type
Injury
Date Received
October 7, 2019
Date of Event
October 1, 2018
Report Date
January 16, 2020
Manufacturer
BAYER PHARMA AG
Product Code
HHS
UDI-DI
10888853003051
PMA / PMN Number
P020014
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THIS SPONTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF DEVICE DISLOCATION ('MIGRATION OF ESSURE LOCATION OF DEVICE: COULD NOT BE FOUND') IN AN ADULT FEMALE PATIENT WHO HAD ESSURE (BATCH NO. 2222096) INSERTED FOR FEMALE STERILISATION. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. THE PATIENT'S MEDICAL HISTORY INCLUDED GALLBLADDER REMOVAL, PARATUBAL CYST, CARPAL TUNNEL RELEASE, DIABETES, HYPERTENSION, HEART DISEASE, UNSPECIFIED, UTERINE BLEEDING, DYSFUNCTIONAL UTERINE BLEEDING, HYPERLIPIDEMIA AND GERD. CONCURRENT CONDITIONS INCLUDED MENOMETRORRHAGIA. CONCOMITANT PRODUCTS INCLUDED MEDROXYPROGESTERONE ACETATE (DEPO-PROVERA) AND RANITIDINE HYDROCHLORIDE (ZANTAC). ON (B)(6) 2010, THE PATIENT HAD ESSURE INSERTED. IN (B)(6) 2010, THE PATIENT EXPERIENCED DYSMENORRHOEA ("DYSMENORRHEA (CRAMPING),") AND DYSPAREUNIA ("DYSPAREUNIA (PAINFUL SEXUAL INTERCOURSE)"). IN (B)(6) 2010, THE PATIENT EXPERIENCED PELVIC PAIN ("PELVIC PAIN"), VAGINAL HAEMORRHAGE ("ABNORMAL BLEEDING (VAGINAL)") AND MENORRHAGIA ("MENORRHAGIA"). IN (B)(6) 2018, THE PATIENT EXPERIENCED DEVICE DISLOCATION (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED). THE PATIENT WAS TREATED WITH SURGERY (HYSTERECTOMY WITH UNILATERAL SALPINGECTOMY). ESSURE WAS REMOVED ON (B)(6) 2018. AT THE TIME OF THE REPORT, THE DEVICE DISLOCATION AND DYSMENORRHOEA OUTCOME WAS UNKNOWN AND THE PELVIC PAIN, VAGINAL HAEMORRHAGE, MENORRHAGIA AND DYSPAREUNIA HAD RESOLVED. THE REPORTER CONSIDERED DEVICE DISLOCATION, DYSMENORRHOEA, DYSPAREUNIA, MENORRHAGIA, PELVIC PAIN AND VAGINAL HAEMORRHAGE TO BE RELATED TO ESSURE. THE REPORTER COMMENTED: ESSURE DEVICE WAS PLACED WITHOUT ANY DIFFICULTY, AT THIS TIME WITH APPROXIMATELY 3 OR 4 COILS NOTED. DIAGNOSTIC RESULTS (NORMAL RANGES ARE PROVIDED IN PARENTHESIS IF AVAILABLE): HYSTEROSALPINGOGRAM - ON (B)(6) 2010: FAILURE TO OCCLUDE (CLOSE) FALLOPIAN TUBES; ON (B)(6)2010: TOTAL BILATERAL OCCLUSION. PATHOLOGY TEST - ON (B)(6) 2018: UTERUS, CERVIX AND RIGHT FALLOPIAN TUBE": A UTERINE BODY WITH ATTACHED CERVIX AND SEPARATE FALLOPIAN TUBE. THE FALLOPIAN TUBE IS 3.5 CM IN LENGTH BY UP TO 0.5 CM IN DIAMETER. THERE IS FIMBRIA PRESENT AT ONE END OF THE SPECIMEN ALONG WITH A 1 CM IN GREATEST DIMENSION SEROUS FLUID FILLED PARATUBAL CYST. IN THE CORNU OF THE UTERUS THERE ARE TWO SILVER COILS GROSSLY CONSISTENT WITH ESSURE DEVICES. MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES: ON 26-DEC-2019: PFS RECEIVED LOT NUMBER WAS ADDED. MEDICAL HISTORY, REPORTER INFORMATION WERE ADDED. A TECHNICAL INVESTIGATION WILL BE CONDUCTED, INCLUDING A BATCH REVIEW OF COMPLAINT RECORDS AND OTHER RELEVANT DATA; SHOULD ANY NEW AND REPORTABLE INFORMATION BECOME AVAILABLE FROM OUR INVESTIGATION, THIS WILL BE PROVIDED IN A SUPPLEMENTARY REPORT.

Additional Manufacturer Narrative · 0

THIS SPONTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF DEVICE DISLOCATION ('MIGRATION OF ESSURE LOCATION OF DEVICE: COULD NOT BE FOUND') IN AN ADULT FEMALE PATIENT WHO HAD ESSURE (BATCH NO: 2222096- NOT VALID) INSERTED FOR FEMALE STERILISATION. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. THE PATIENT'S MEDICAL HISTORY INCLUDED GALLBLADDER REMOVAL, PARATUBAL CYST, CARPAL TUNNEL RELEASE, DIABETES, HYPERTENSION, HEART DISEASE, UNSPECIFIED, UTERINE BLEEDING, DYSFUNCTIONAL UTERINE BLEEDING, HYPERLIPIDEMIA AND GERD. CONCURRENT CONDITIONS INCLUDED MENOMETRORRHAGIA. CONCOMITANT PRODUCTS INCLUDED MEDROXYPROGESTERONE ACETATE (DEPO-PROVERA) AND RANITIDINE HYDROCHLORIDE (ZANTAC). ON (B)(6) 2010, THE PATIENT HAD ESSURE INSERTED. ON (B)(6) 2010, THE PATIENT EXPERIENCED DYSMENORRHOEA ("DYSMENORRHEA (CRAMPING),") AND DYSPAREUNIA ("DYSPAREUNIA (PAINFUL SEXUAL INTERCOURSE)"). ON (B)(6) 2010, THE PATIENT EXPERIENCED PELVIC PAIN ("PELVIC PAIN"), VAGINAL HAEMORRHAGE ("ABNORMAL BLEEDING (VAGINAL)") AND MENORRHAGIA ("MENORRHAGIA"). ON (B)(6) 2018, THE PATIENT EXPERIENCED DEVICE DISLOCATION (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED). THE PATIENT WAS TREATED WITH SURGERY (HYSTERECTOMY WITH UNILATERAL SALPINGECTOMY). ESSURE WAS REMOVED ON (B)(6) 2018. AT THE TIME OF THE REPORT, THE DEVICE DISLOCATION AND DYSMENORRHOEA OUTCOME WAS UNKNOWN AND THE PELVIC PAIN, VAGINAL HAEMORRHAGE, MENORRHAGIA AND DYSPAREUNIA HAD RESOLVED. THE REPORTER CONSIDERED DEVICE DISLOCATION, DYSMENORRHOEA, DYSPAREUNIA, MENORRHAGIA, PELVIC PAIN AND VAGINAL HAEMORRHAGE TO BE RELATED TO ESSURE. THE REPORTER COMMENTED: ESSURE DEVICE WAS PLACED WITHOUT ANY DIFFICULTY, AT THIS TIME WITH APPROXIMATELY 3 OR 4 COILS NOTED. DIAGNOSTIC RESULTS (NORMAL RANGES ARE PROVIDED IN PARENTHESIS IF AVAILABLE): HYSTEROSALPINGOGRAM: ON (B)(6) 2010: FAILURE TO OCCLUDE (CLOSE) FALLOPIAN TUBES; ON (B)(6)2010: TOTAL BILATERAL OCCLUSION. PATHOLOGY TEST: ON (B)(6) 2018: UTERUS, CERVIX AND RIGHT FALLOPIAN TUBE": A UTERINE BODY WITH ATTACHED CERVIX AND SEPARATE FALLOPIAN TUBE. THE FALLOPIAN TUBE IS 3.5 CM IN LENGTH BY UP TO 0.5 CM IN DIAMETER. THERE IS FIMBRIA PRESENT AT ONE END OF THE SPECIMEN ALONG WITH A 1 CM IN GREATEST DIMENSION SEROUS FLUID FILLED PARATUBAL CYST. IN THE CORNU OF THE UTERUS THERE ARE TWO SILVER COILS GROSSLY CONSISTENT WITH ESSURE DEVICES. LOT NUMBER REPORTED 2222096 IS INVALID. MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES: ON 13-JAN-2020: UPDATE OF INFORMATION (BATCH IS NOT VALID). A TECHNICAL INVESTIGATION WILL BE CONDUCTED, INCLUDING A BATCH REVIEW, AND A REVIEW OF COMPLAINT RECORDS AND OTHER RELEVANT DATA; SHOULD ANY NEW AND REPORTABLE INFORMATION BECOME AVAILABLE FROM OUR INVESTIGATION, THIS WILL BE PROVIDED IN A SUPPLEMENTARY REPORT.

Description of Event or Problem · 1

THIS SPONTANEOUS CASE WAS REPORTED BY A LAWYER AND DESCRIBES THE OCCURRENCE OF DEVICE DISLOCATION ('MIGRATION OF ESSURE LOCATION OF DEVICE: COULD NOT BE FOUND') IN AN ADULT FEMALE PATIENT WHO HAD ESSURE INSERTED FOR FEMALE STERILISATION. THE OCCURRENCE OF ADDITIONAL NON-SERIOUS EVENTS IS DETAILED BELOW. THE PATIENT'S MEDICAL HISTORY INCLUDED GALLBLADDER REMOVAL AND PARATUBAL CYST. CONCURRENT CONDITIONS INCLUDED MENOMETRORRHAGIA. CONCOMITANT PRODUCTS INCLUDED MEDROXYPROGESTERONE ACETATE (DEPO-PROVERA) AND RANITIDINE HYDROCHLORIDE (ZANTAC). ON (B)(6) 2010, THE PATIENT HAD ESSURE INSERTED. IN (B)(6) 2010, THE PATIENT EXPERIENCED DYSMENORRHOEA ("DYSMENORRHEA (CRAMPING),") AND DYSPAREUNIA ("DYSPAREUNIA (PAINFUL SEXUAL INTERCOURSE)"). IN (B)(6) 2010, THE PATIENT EXPERIENCED PELVIC PAIN ("PELVIC PAIN"), VAGINAL HAEMORRHAGE ("ABNORMAL BLEEDING (VAGINAL)") AND MENORRHAGIA ("MENORRHAGIA"). IN (B)(6) 2018, THE PATIENT EXPERIENCED DEVICE DISLOCATION (SERIOUSNESS CRITERIA MEDICALLY SIGNIFICANT AND INTERVENTION REQUIRED). THE PATIENT WAS TREATED WITH SURGERY (HYSTERECTOMY WITH UNILATERAL SALPINGECTOMY). ESSURE WAS REMOVED ON (B)(6) 2018. AT THE TIME OF THE REPORT, THE DEVICE DISLOCATION AND DYSMENORRHOEA OUTCOME WAS UNKNOWN AND THE PELVIC PAIN, VAGINAL HAEMORRHAGE, MENORRHAGIA AND DYSPAREUNIA HAD RESOLVED. THE REPORTER CONSIDERED DEVICE DISLOCATION, DYSMENORRHOEA, DYSPAREUNIA, MENORRHAGIA, PELVIC PAIN AND VAGINAL HAEMORRHAGE TO BE RELATED TO ESSURE. THE REPORTER COMMENTED: ESSURE DEVICE WAS PLACED WITHOUT ANY DIFFICULTY, AT THIS TIME WITH APPROXIMATELY 3 OR 4 COILS NOTED. DIAGNOSTIC RESULTS (NORMAL RANGES ARE PROVIDED IN PARENTHESIS IF AVAILABLE): HYSTEROSALPINGOGRAM ON (B)(6) 2010: FAILURE TO OCCLUDE (CLOSE) FALLOPIAN TUBES; ON (B)(6) 2010: TOTAL BILATERAL OCCLUSION. PATHOLOGY TEST - ON (B)(6) 2018: UTERUS, CERVIX AND RIGHT FALLOPIAN TUBE": A UTERINE BODY WITH ATTACHED CERVIX AND SEPARATE FALLOPIAN TUBE. THE FALLOPIAN TUBE IS 3.5 CM IN LENGTH BY UP TO 0.5 CM IN DIAMETER. THERE IS FIMBRIA PRESENT AT ONE END OF THE SPECIMEN ALONG WITH A 1 CM IN GREATEST DIMENSION SEROUS FLUID FILLED PARATUBAL CYST. IN THE CORNU OF THE UTERUS THERE ARE TWO SILVER COILS GROSSLY CONSISTENT WITH ESSURE DEVICES. MOST RECENT FOLLOW-UP INFORMATION INCORPORATED ABOVE INCLUDES: ON 17-SEP-2019: PFS AND MR RECEIVED. REPORTERS INFORMATION UPDATED. EVENT: INJURY WERE UPDATED TO ABNORMAL BLEEDING (VAGINAL). NEW EVENT'S: MENORRHAGIA), DYSMENORRHEA (CRAMPING), DYSPAREUNIA (PAINFUL SEXUAL INTERCOURSE), MIGRATION OF ESSURE LOCATION OF DEVICE: COULD NOT BE FOUND, PAIN: PELVIC WERE ADDED. MEDICAL HISTORY, LAB DATA, CONCOMITANT DRUGS, WERE ADDED. INCIDENT: NO LOT NUMBER OR DEVICE SAMPLE WAS RECEIVED IN THIS CASE. AT THIS TIME, WE HAVE NO INFORMATION SUGGESTING THAT THE DEVICE FAILED TO MEET ITS SPECIFICATIONS. WE WILL CONDUCT A REVIEW OF OUR COMPLAINT RECORDS INFORMATION BECOME AVAILABLE FROM OUR INVESTIGATION, THIS WILL BE AND OTHER NON-CONFORMANCES DATA; SHOULD ANY NEW AND REPORTABLE PROVIDED IN A SUPPLEMENTARY REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
956758 ESSURE TRANSCERVICAL CONTRACEPTIVE TUBAL OCCLUSION DEVICE HHS BAYER PHARMA AG ESS305 2222096-NOTVALID 10888853003051

Patients

Seq Age Sex Outcome Treatment
1 38 YR Other| R DEPO-PROVERA| DEPO-PROVERA| DEPO-PROVERA| ZANTAC| ZANTAC| ZANTAC