MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,02,05,07 report with the FDA on 2009-03-05 for ENTERYX PROCEDURE KIT M00572600 manufactured by Boston Scientific Corporation- Marlborough.
[17061298]
It was reported to boston scientific corporation on september 6, 2005 that an enteryx procedure kit was implanted in a patient six months prior (patient age, gender and weight are unknown). Six injections were performed, delivering a total of 8. 7cc's of enteryx solution to the patient. Three injections were performed intramuscularly and 1. 1cc was delivered in 3 submucosal injections. According to the complainant, the patient experienced an onset of mild dysphagia and distal esophageal stricture after the procedure. The patient reports the mild dysphagia resolved five days later. The following month, the patient reports the dysphagia has returned and has increased to moderate. This was reduced to mild dysphagia eight days later. Approx two months later, during the patient's 3-month followup visit, the patient had an esophagogastroduodenoscopy (egd) with dilation for treatment of the distal esophageal stricture. The dysphagia was reported as resolved fifteen days later. Approx two months later, the patient had another esophagogastroduodenoscopy (egd) with dilation. The intensity of the stricture was reduced to mild from moderate. A small gastric cardia polyp was also noted during the procedure.
Patient Sequence No: 1, Text Type: D, B5
[17237824]
The device remains implanted in the patient; therefore, a device evaluation cannot be performed. Note: this product was removed from the global market in september 2005. Boston scientific corporation no longer produces the reported product.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 3005099803-2008-01928 |
| MDR Report Key | 1333205 |
| Report Source | 00,02,05,07 |
| Date Received | 2009-03-05 |
| Date of Report | 2005-09-06 |
| Date of Event | 2005-03-14 |
| Date Mfgr Received | 2005-09-06 |
| Device Manufacturer Date | 2005-01-10 |
| Date Added to Maude | 2009-03-05 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | KEN HIRAKAWA |
| Manufacturer Street | 100 BOSTON SCIENTIFIC WAY |
| Manufacturer City | MARLBOROUGH MA 01752 |
| Manufacturer Country | US |
| Manufacturer Postal | 01752 |
| Manufacturer Phone | 5086836264 |
| Single Use | 3 |
| Remedial Action | OT |
| Previous Use Code | 3 |
| Removal Correction Number | Z-0040-06 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ENTERYX PROCEDURE KIT |
| Generic Name | CERAMICS, CALCIUM TRIPHOSPHATE/HYDROXYPATITE, NON-LOAD BEARING USES |
| Product Code | LMN |
| Date Received | 2009-03-05 |
| Model Number | M00572600 |
| Lot Number | 41228 |
| Device Expiration Date | 2006-12-31 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION- MARLBOROUGH |
| Manufacturer Address | 100 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 US 01752 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2009-03-05 |