MAUDE MDR 970527

MDR report key
970527
Report number
6000043-2007-00144
Event key
0
Event type
3
Date of event
2006-03-12
Date received
2007-12-28
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
NANCY CUTINO
Address
100 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 US
Phone
508-508-5086
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1VESICA SLING KITBOSTON SCIENTIFIC CORPORATIONFHKM0068201000820-100UNKYRN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12007-12-2801. H

Event Narratives#

D

Patient 1

NOTE: BOSTON SCIENTIFIC CORPORATION BECAME AWARE OF THE REPORTED EVENT THROUGH VARIOUS LEGAL DOCUMENTS; THE EVENTS HAD NOT BEEN PREVIOUSLY REPORTED TO BSC. BSC RECEIVED A LETTER FROM THE PATIENT'S ATTORNEY WHICH REPORTED THAT IN 1998, A PATIENT (AGE AND WEIGHT UNKNOWN) UNDERWENT A BLADDER NECK SUSPENSION SURGERY USING THE VESICA SLING SYSTEM. ACCORDING TO THE COMPLAINANT, IN 2006, THE PATIENT WENT TO THE EMERGENCY ROOM COMPLAINING OF "KNOTS IN HER ABDOMEN" (TREATMENT UNKNOWN). IT WAS REPORTED THAT APPROXIMATELY IN APPROX TWO AND A HALF MONTHS LATER, A PIECE OF METAL WAS PROTRUDING FROM WHERE SHE PREVIOUSLY HAD A LUMP. ONE OF THE METAL ANCHORS FROM THE VESICA SLING SYSTEM HAD BROKEN LOOSE AND HAD MADE ITS WAY TO THE SURFACE OF HER SKIN. THE NATURE OF THE PATIENT OUTCOME IS UNKNOWN AT THIS TIME. WE ARE UNABLE TO OBTAIN ANY FURTHER INFORMATION REGARDING THIS EVENT OR THE PATIENT'S CONDITION. IT IS UNKNOWN AT THIS TIME IF MEDICAL OR SURGICAL INTERVENTION WAS REQUIRED.

N

Patient 1

THE COMPLAINANT INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION SINCE IT WAS IMPLANTED; THEREFORE, A FAILURE ANALYSIS IS NOT AVAILABLE, AND WE ARE NOT ABLE TO DETERMINE IF THE DEVICE MET SPECIFICATION. IT WAS NOT POSSIBLE TO IDENTIFY ANY POTENTIAL LOTS FOR THIS PRODUCT THROUGH A SHIP HISTORY RECORD REVIEW DUE TO THE AGE OF THE PRODUCT. THE OCTOBER 2007 15-MONTH SLING FIXATION COMPLAINT TREND REPORT, INCLUSIVE OF ALL FAILURE MODES, WAS REVIEWED; NO ADVERSE TREND WAS NOTED.