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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION AMS SPECTRA CONCEALABLE PENILE PROSTHESIS; PROSTHESIS PENILE

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BOSTON SCIENTIFIC CORPORATION AMS SPECTRA CONCEALABLE PENILE PROSTHESIS; PROSTHESIS PENILE Back to Search Results
Model Number 720074-02
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Unspecified Infection (1930)
Event Date 12/21/2021
Event Type  Injury  
Event Description
It was reported that the patient had the spectra penile prosthesis removed due to an infection.A new tactra penile prosthesis was implanted.Following the surgery, the patient was stable and the event resolved.
 
Manufacturer Narrative
Investigation summary: based on the information available, the cause that contributed to the reported infection could not be established as the product is not available for analysis.Device history record review (dhr): the device history record review (dhr) confirmed that the device met all material, assembly and performance specifications.A risk review confirmed that the event is accounted for in the risk documentation.Device technical analysis: the device was not available for analysis; therefore, no physical or visual analysis of the product could be performed.Labeling review: a review of the device instructions for use (ifu) was completed and did not review any evidence of device off-label use or failure to follow instructions.Infection is documented as adverse events.Investigation conclusion: based on this investigation and all information available, a conclusion code of known inherent risk of device was assigned to this investigation.Risk review and labeling review identified that the adverse event of infection is a known risk of the device.The cause of the infection was not established by physician, although infection is included in the labelling documentation for infection device as an adverse event of implant surgical procedure of device and also the risks, benefits, and potential adverse events of all available treatment options should be discussed with the patient and considered by the physician and patient when choosing a treatment option is included in the document, therefore a conclusion code of known inherent risk of device was chosen.
 
Event Description
It was reported that the patient had the spectra penile prosthesis removed due to an infection.A new tactra penile prosthesis was implanted.Following the surgery, the patient was stable and the event resolved.
 
Manufacturer Narrative
Investigation summary: with all the available information, boston scientific concludes, based on analysis results, the cause that contributed to the infection issue was not confirmed.Device history record review (dhr): the device history record review (dhr) confirmed that the device met all material, assembly and performance specifications.Review of the manufacturing records found no evidence that the device failed to meet applicable product specifications prior to shipment from boston scientific.Additionally, the reported events do not contain an allegation against the labeling.Device technical analysis: upon receipt at our post market quality assurance laboratory, this device was thoroughly analyzed.The spectra penile prosthesis (spp) cylinders were visually inspected, microscope examined and functionally tested and no visual damages were found upon inspection.Both cylinders passed the bend test with a force readout of less than 1390 grams.The cylinders, therefore, performed within specification.Product analysis was unable to confirm the reported events.Labeling review: a labeling review was performed and according to the app instruction for use document, infection is documented as an adverse event.Also, there is no evidence that the device was used or handled improperly.Investigation conclusion: based on this investigation a clear probable cause for the event was established; therefore, the investigation conclusion code of known inherent risk of device was chosen, as infection is included in the product labeling and hazard analysis.
 
Event Description
It was reported that the patient had the spectra penile prosthesis removed due to an infection.A new tactra penile prosthesis was implanted.Following the surgery, the patient was stable and the event resolved.
 
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Brand Name
AMS SPECTRA CONCEALABLE PENILE PROSTHESIS
Type of Device
PROSTHESIS PENILE
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer Contact
alyson harris
4100 hamline avenue north
building c
saint paul, MN 55112
4089353452
MDR Report Key13100392
MDR Text Key282901804
Report Number2124215-2021-38927
Device Sequence Number1
Product Code FAE
UDI-Device Identifier00878953005287
UDI-Public00878953005287
Combination Product (y/n)N
Reporter Country CodeKS
PMA/PMN Number
K090663
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date 02/25/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Expiration Date11/08/2021
Device Model Number720074-02
Device Catalogue Number720074-02
Device Lot Number0155876001
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/31/2022
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 12/22/2021
Initial Date FDA Received12/28/2021
Supplement Dates Manufacturer Received01/07/2022
02/04/2022
Supplement Dates FDA Received01/28/2022
02/25/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/08/2016
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) Hospitalization; Required Intervention;
Patient Age76 YR
Patient SexMale
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