SOLYX SIS SYSTEM

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,consum report with the FDA on 2020-03-18 for SOLYX SIS SYSTEM manufactured by Boston Scientific Corporation.

Event Text Entries

[189010914] The complainant was unable to provide the upn and lot number of the suspect device. Therefore, the manufacture and expiration dates are unknown. (b)(4). The device has not been received for analysis; therefore, a failure analysis of the complaint device could not be completed. If any further relevant information is identified, a supplemental medwatch will be filed.
Patient Sequence No: 1, Text Type: N, H10


[189010915] It was reported to boston scientific corporation that the patient was implanted with a solyx sling on (b)(6) 2014. The associated post-operative diagnosis was cystocele, rectocele, stress incontinence, recurrent urinary tract infections. As reported by the patient's attorney, the patient underwent a revision surgery related to the solyx device on (b)(6) 2017. The associated post-operative diagnosis was mesh erosion into the left bladder neck, stress urinary incontinence, dyspareunia, hematuria, recurrent urinary tract infections, pelvic pain. Boston scintific has been unable to obtain additional information regarding the event to date.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005099803-2020-01172
MDR Report Key9846550
Report SourceCOMPANY REPRESENTATIVE,CONSUM
Date Received2020-03-18
Date of Report2020-03-18
Date of Event2017-05-31
Date Mfgr Received2020-02-19
Date Added to Maude2020-03-18
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 ContactCAROLE MORLEY
Manufacturer Street300 BOSTON SCIENTIFIC WAY
Manufacturer CityMARLBOROUGH MA 01752
Manufacturer CountryUS
Manufacturer Postal01752
Manufacturer Phone5086834015
Manufacturer G1BOSTON SCIENTIFIC CORPORATION
Manufacturer Street780 BROOKSIDE DRIVE
Manufacturer CitySPENCER IN 47460
Manufacturer CountryUS
Manufacturer Postal Code47460
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSOLYX SIS SYSTEM
Generic NameMESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC, FOR STRESS URINARY INCONTINENCE, FEMA
Product CodePAH
Date Received2020-03-18
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBOSTON SCIENTIFIC CORPORATION
Manufacturer Address300 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 US 01752


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-18

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