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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION WALLFLEX COLONIC SOFT STENT SYSTEM WITH ANCHOR LOCK DELIVERY SYSTEM; STENT, COLONIC, METALIC, EXPANDABLE

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BOSTON SCIENTIFIC CORPORATION WALLFLEX COLONIC SOFT STENT SYSTEM WITH ANCHOR LOCK DELIVERY SYSTEM; STENT, COLONIC, METALIC, EXPANDABLE Back to Search Results
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/16/2023
Event Type  Injury  
Event Description
Boston scientific corporation became aware of the following event through the article, "outcomes of colon self-expandable metal stents for malignant vs benign indications at a tertiary care center and review of literature", by walayat, s., et al.Per the literature, a retrospective reviewed was performed to all patient who underwent colonic self-expanding metal stent placement from august 2004 through august 2022 at university of wisconsin.There were sixty-three patients over the age of 18 who underwent colonic stent placement.Fifty-five cases were for malignant indication, and eight were for benign conditions.The benign strictures included diverticular disease stricturing (n = 4), fistula closure (n = 2), extrinsic fibroid compression (n = 1), and ischemic stricture (n = 1).Forty-three of the malignant cases were due to intrinsic obstruction from primary or recurrent colon cancer; 12 were from extrinsic compression.Fifty-four strictures occurred on the left side, 3 occurred on the right and the rest in transverse colon.According to the literature, a case of a 43-year-old, male, with tumor location at the sigmoid colon, was successfully implanted with a walflex colonic stent.However, the patient required repeat stenting at 12 months after the initial stent placement.
 
Manufacturer Narrative
Block b3: the exact date of event was not reported.The article published date is used for the estimated date of event.Block d4, h4: the literature article did not provide the suspect device upn and lot number; therefore, the lot expiration and device manufacture dates are unknown.Block g2: literature source: walayat, s., et al."outcomes of colon self-expandable metal stents for malignant vs benign indications at a tertiary care center and review of literature".World j gastrointest endosc 2023; 15(4): 309-318.Doi: 10.4253/wjge.V15.I4.309.Block h6: imdrf impact code f2202 captures the additional endoscopic procedure for the repeat stenting procedure.Imdrf impact code f2301 captures the additional stent implanted.
 
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Brand Name
WALLFLEX COLONIC SOFT STENT SYSTEM WITH ANCHOR LOCK DELIVERY SYSTEM
Type of Device
STENT, COLONIC, METALIC, EXPANDABLE
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
ballybrit business park
galway
EI  
Manufacturer Contact
carole morley
300 boston scientific way
marlborough, MA 01752
5086834015
MDR Report Key18603133
MDR Text Key334036213
Report Number3005099803-2024-00155
Device Sequence Number1
Product Code MQR
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Literature,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 01/29/2024
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 Health Professional
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 01/03/2024
Initial Date FDA Received01/29/2024
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 Age43 YR
Patient SexMale
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