ESSURE ESS305

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,other report with the FDA on 2019-11-29 for ESSURE ESS305 manufactured by Bayer Pharma Ag.

Event Text Entries

[177252573] This spontaneous case was reported by a lawyer and describes the occurrence of back pain ('back pain'), sjogren's syndrome ('sjogren's syndrome') and hallucination ('seeing halos at night') in a female patient who had essure inserted. The occurrence of additional non-serious events is detailed below. On an unknown date, the patient had essure inserted. On an unknown date, the patient experienced back pain (seriousness criteria medically significant and intervention required), sjogren's syndrome (seriousness criterion medically significant), hallucination (seriousness criterion medically significant), arthralgia ("joint pain"), headache ("headache"), fatigue ("fatigued"), photophobia ("light sensitivity"), myalgia ("muscle pain"), eye pruritus ("itchy eyes"), dry eye ("dry eyes"), vision blurred ("blurred vision"), palpitations ("heart palpitation"), peripheral swelling ("swelling of hands and feet"), hypoaesthesia ("numbing of hands or feet"), feeling abnormal ("brain fog"), respiratory disorder ("respiratory issues"), gingival bleeding ("bleeding gums"), plicated tongue ("fissures in tongue"), candida infection ("thrush/ candidia like symptoms"), rash ("rashes/ bumps on foot"), urticaria ("hives"), rash papular ("bumps on back/foot"), pruritus ("back side with severe itching"), lymphadenopathy ("swollen glands"), pyrexia ("low grade fevers"), dyspepsia ("digestive issues") and fibromyalgia ("fibromyalgia") and was found to have antinuclear antibody positive ("ana positive"). The patient was treated with surgery (salpingectomy and hysterectomy). Essure was removed. At the time of the report, the back pain, sjogren's syndrome, hallucination, arthralgia, fatigue, photophobia, myalgia, eye pruritus, dry eye, vision blurred, palpitations, peripheral swelling, hypoaesthesia, feeling abnormal, respiratory disorder, gingival bleeding, plicated tongue, candida infection, rash, urticaria, rash papular, pruritus, lymphadenopathy, pyrexia, dyspepsia, fibromyalgia and antinuclear antibody positive outcome was unknown. The reporter considered antinuclear antibody positive, arthralgia, back pain, candida infection, dry eye, dyspepsia, eye pruritus, fatigue, feeling abnormal, fibromyalgia, gingival bleeding, hallucination, headache, hypoaesthesia, lymphadenopathy, myalgia, palpitations, peripheral swelling, photophobia, plicated tongue, pruritus, pyrexia, rash, rash papular, respiratory disorder, sjogren's syndrome, urticaria and vision blurred to be related to essure. 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 and other non-conformances data; should any new and reportable information become available from our investigation, this will be provided in a supplementary report.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2951250-2019-11860
MDR Report Key9391858
Report SourceCONSUMER,OTHER
Date Received2019-11-29
Date of Report2019-11-29
Date Mfgr Received2019-11-14
Date Added to Maude2019-11-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactK SHAW LAMBERSON
Manufacturer Street100 BAYER BLVD, P.O. BOX 915
Manufacturer CityWHIPPANY NJ 07981
Manufacturer CountryUS
Manufacturer Postal07981
Manufacturer G1BAYER PHARMA AG
Manufacturer StreetM
Manufacturer CityBERLIN, 13353
Manufacturer CountryGM
Manufacturer Postal Code13353
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameESSURE
Generic NameTRANSCERVICAL CONTRACEPTIVE TUBAL OCCLUSION DEVICE
Product CodeHHS
Date Received2019-11-29
Model NumberESS305
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerBAYER PHARMA AG
Manufacturer AddressM?LLERSTR. 178 BERLIN, 13353 GM 13353


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2019-11-29

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