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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION PINNACLE PELVIC FLOOR REPAIR KITS; MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC, FOR PELVIC ORGAN PROLAPSE, TRANSVAGIN

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BOSTON SCIENTIFIC CORPORATION PINNACLE PELVIC FLOOR REPAIR KITS; MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC, FOR PELVIC ORGAN PROLAPSE, TRANSVAGIN Back to Search Results
Model Number 831-705
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problems Erosion (1750); Pain (1994); Depression (2361); Dyspareunia (4505); Urinary Incontinence (4572)
Event Date 11/01/2016
Event Type  Injury  
Event Description
It was reported to boston scientific corporation that a pinnacle was implanted on (b)(6) 2016 and an obtryx ii was implanted on an unspecified date.The patient experienced complications, surgical and nonsurgical treatment.Patient symptoms include: eep (erosion/extrusion/protrusion of the mesh); back pain; vaginal pain; pelvic pain; groin pain; anal pain; rectal pain; thigh pain; inability to have intercourse; recurrent incontinence; aggravated incontinence; psychiatric injury.Surgical interventions: on an unspecified date the patient underwent further surgery regarding the pinnacle implant for the following purpose: anterior and posterior repair with excision of mesh and sacrospinous hitch.Nonsurgical treatments: on (b)(6) 2016 the patient commenced pain medication: opioids for: pain relief.On (b)(6) 2021 the patient commenced incontinence medication: ditropan for: urinary incontinence.On (b)(6) 2016 the patient commenced psychological medication: prozac for: depression.The patient was treated with physiotherapy treatment (including pelvic floor exercises or training).On (b)(6) 2016 the patient commenced topical treatment (including oestrogen cream): livial for: oestrogen tablets.The patient was treated with pain medication.Device 1 of 2.
 
Manufacturer Narrative
(b)(6).The complainant was unable to provide the suspect device upn and lot number; therefore, the lot expiration and device manufacture dates are unknown.The upn provided was chosen as a representative upn to capture the implanted device.The complainant indicated that the device is not available for return; 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.
 
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Brand Name
PINNACLE PELVIC FLOOR REPAIR KITS
Type of Device
MESH, SURGICAL, SYNTHETIC, UROGYNECOLOGIC, FOR PELVIC ORGAN PROLAPSE, TRANSVAGIN
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
780 brookside drive
spencer IN 47460
Manufacturer Contact
carole morley
300 boston scientific way
marlborough, MA 01752
5086834015
MDR Report Key12930735
MDR Text Key286929942
Report Number3005099803-2021-07385
Device Sequence Number1
Product Code OTP
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K071957
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Consumer
Reporter Occupation Other
Type of Report Initial
Report Date 12/04/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/04/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Model Number831-705
Device Catalogue Number831-705
Was Device Available for Evaluation? No
Date Manufacturer Received11/10/2021
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age60 YR
Patient SexFemale
Patient Weight83 KG
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