MEDPLAST MEDICAL, INC. REZUM; UNIT, ELECTROSURGICAL ENDOSCOPIC (WITH OR WITHOUT ACCESSORIES)
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Model Number D2201 |
Device Problem
Adverse Event Without Identified Device or Use Problem (2993)
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Patient Problems
Headache (1880); Hematuria (2558); Patient Problem/Medical Problem (2688)
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Event Date 10/29/2018 |
Event Type
Injury
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Event Description
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During procedure, a total of nine treatments were delivered.No adverse event occurred during the procedure.The same day post procedure the patient experienced continuous headache for which ibuprofen (unknown dose) was administered.The patient was discharged post procedure with an indwelling catheter.At 97 days post the index procedure, the patient experienced hematuria, and at 134 days, a single episode of discharge of tissue material during urination.There was no treatment administered for the two reported symptoms.The symptom of intermittent hematuria resolved 11 days post onset symptom, and the symptom of single episode discharge of tissue material during urination resolved the same day post onset symptom.The patient indwelling catheter was removed 183 days post the index procedure.The investigator assessment of the patient headache was assessed as unlikely related to procedure and device.The patient symptom of hematuria and discharge of tissue material during urination were assessed as probable related to procedure and device.The clinical endpoint committee (cec) adjudicated the patient symptom of headache as possible related to the procedure and unlikely related to the device.The patient symptoms of hematuria and discharge of tissue material during urination, per cec, there was no adjudication results required.
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Event Description
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During procedure, a total of nine treatments were delivered.No adverse event occurred during the procedure.The same day post procedure the patient experienced continuous headache for which ibuprofen (unknown dose) was administered.The patient was discharged post procedure with an indwelling catheter.At 97 days post the index procedure, the patient experienced hematuria, and at 134 days, a single episode of discharge of tissue material during urination.There was no treatment administered for the two reported symptoms.The symptom of intermittent hematuria resolved 11 days post onset symptom, and the symptom of single episode discharge of tissue material during urination resolved the same day post onset symptom.The patient indwelling catheter was removed 183 days post the index procedure.The investigator assessment of the patient headache was assessed as unlikely related to procedure and device.The patient symptom of hematuria and discharge of tissue material during urination were assessed as probable related to procedure and device.The clinical endpoint committee (cec) adjudicated the patient symptom of headache as possible related to the procedure and unlikely related to the device.The patient symptoms of hematuria and discharge of tissue material during urination, per cec, there was no adjudication results required.This report if for headache symptom.
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Manufacturer Narrative
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Correction to patient codes.Refer to manufacturer report: 2937094-2019-60843 for hematuria symptom and manufacturer report: 2937094-2019-60844 for discharge of tissue material during urination symptom.
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Manufacturer Narrative
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The device is not available for analysis.A review of the device ifu and operators manual was completed and did not reveal any evidence of device misuse, off-label use, or failure to follow instructions.The potential cause and controls for complaints related to clinical events were identified.Based on the information currently available, an evaluation conclusion code of no problem detected was assigned to this investigation.
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Event Description
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During procedure, a total of nine treatments were delivered.No adverse event occurred during the procedure.The same day post procedure the patient experienced continuous headache for which ibuprofen (unknown dose) was administered.The patient was discharged post procedure with an indwelling catheter.At 97 days post the index procedure, the patient experienced hematuria, and at 134 days, a single episode of discharge of tissue material during urination.There was no treatment administered for the two reported symptoms.The symptom of intermittent hematuria resolved 11 days post onset symptom, and the symptom of single episode discharge of tissue material during urination resolved the same day post onset symptom.The patient indwelling catheter was removed 183 days post the index procedure.The investigator assessment of the patient headache was assessed as unlikely related to procedure and device.The patient symptom of hematuria and discharge of tissue material during urination were assessed as probable related to procedure and device.The clinical endpoint committee (cec) adjudicated the patient symptom of headache as possible related to the procedure and unlikely related to the device.The patient symptoms of hematuria and discharge of tissue material during urination, per cec, there was no adjudication results required.This report if for headache symptom.
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