ESSURE ESS205

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,foreign,other report with the FDA on 2020-03-27 for ESSURE ESS205 manufactured by Bayer Pharma Ag.

Event Text Entries

[188720860] This case was initially received via regulatory authority ((b)(6), reference number: (b)(4)) on 24-mar-2020. This spontaneous case was reported by a consumer and describes the occurrence of abdominal distension ('abdominal swelling') in a (b)(6) year old female patient who had essure (ess205) (batch no. 620725) inserted. The occurrence of additional non-serious events is detailed below. On (b)(6) 2006, the patient had essure (ess205) inserted. In 2007, the patient experienced pain in extremity ("roaming pain in the foot"), tooth disorder ("dental problems"), tinnitus ("tinnitus"), ear discomfort ("left ear discomfort"), ear pruritus ("ear itching"), burning sensation ("burning"), blepharophimosis ("blepharophimosis"), pruritus ("itching"), cognitive disorder ("cognitive disorders"), memory impairment ("memory problem"), balance disorder ("balance disturbances"), depression ("depressive tendency") and mental impairment ("disorders including organization of thought"). In 2014, the patient experienced abdominal distension (seriousness criterion medically significant), palpitations ("heart palpitations at night"), fatigue ("persistent fatigue"), neck pain ("cervical pain"), coccydynia ("coccyx pain") and dyspepsia ("digestive disorders") and was found to have weight increased ("significant weight gain"). At the time of the report, the abdominal distension, pain in extremity, tooth disorder, tinnitus, ear discomfort, ear pruritus, burning sensation, blepharophimosis, pruritus, cognitive disorder, memory impairment, balance disorder, depression, palpitations, fatigue, neck pain, coccydynia, weight increased, dyspepsia and mental impairment outcome was unknown. The reporter provided no causality assessment for abdominal distension, balance disorder, blepharophimosis, burning sensation, coccydynia, cognitive disorder, depression, dyspepsia, ear discomfort, ear pruritus, fatigue, memory impairment, mental impairment, neck pain, pain in extremity, palpitations, pruritus, tinnitus, tooth disorder and weight increased with essure (ess205). The reporter commented: she was trying to contact a surgeon-gynaecologist in this first quarter of 2020, to schedule an explantation based on the available information, a review of our complaint records and other relevant data will be conducted; any new and reportable information that becomes available from our investigation will be provided in a supplementary report.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2951250-2020-02758
MDR Report Key9888646
Report SourceCONSUMER,FOREIGN,OTHER
Date Received2020-03-27
Date of Report2020-04-01
Date of Event2014-01-01
Date Mfgr Received2020-03-24
Device Manufacturer Date2006-05-01
Date Added to Maude2020-03-27
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 Received2020-03-27
Model NumberESS205
Lot Number620725
Device Expiration Date2008-04-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBAYER PHARMA AG
Manufacturer AddressM?LLERSTR. 178 BERLIN, 13353 GM 13353


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-27

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