BOSTON SCIENTIFIC CORPORATION 550 840-846

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2008-11-11 for BOSTON SCIENTIFIC CORPORATION 550 840-846 manufactured by Boston Scientific Corporation.

Event Text Entries

[965684] During cystoscopy while physician was lasering the prostate, the tip of the laser filter fell off into the field. It was retrieved in its entirely using a grasper. A second filter was opened and the case continued. Physician: dr. Waldman admitting diagnosis: benign protstatic hypertrophy.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5008962
MDR Report Key1227043
Date Received2008-11-11
Date of Report2008-11-11
Date of Event2008-10-16
Date Added to Maude2008-11-19
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameBOSTON SCIENTIFIC CORPORATION
Generic NameDUO TOME SIDE LITE
Product CodeLNK
Date Received2008-11-11
Model Number550
Catalog Number840-846
Lot Number72000308
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Implant FlagN
Date RemovedB
Device Sequence No1
Device Event Key1282710
ManufacturerBOSTON SCIENTIFIC CORPORATION
Manufacturer AddressONE BOSTON SCIENTIFIC PLACE NATICK MA 017601537 US


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2008-11-11

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