Model Number M00509161 |
Device Problem
Detachment of Device or Device Component (2907)
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Patient Problem
No Clinical Signs, Symptoms or Conditions (4582)
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Event Date 11/07/2022 |
Event Type
malfunction
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Manufacturer Narrative
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(b)(4).The complainant was unable to provide the suspect device upn and lot number; therefore, the lot expiration and device manufacture dates are unknown.
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Event Description
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It was reported to boston scientific corporation that an endovive securi-t replacement bolster was used during a percutaneous endoscopic gastrostomy replacement procedure on (b)(6) 2022.During the procedure, the internal bolster detached.The procedure was completed with a new endovive securi-t replacement bolster.There were no patient complications reported as a result of this event.
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Event Description
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It was reported to boston scientific corporation that an endovive securi-t replacement bolster was used during a percutaneous endoscopic gastrostomy replacement procedure on (b)(6), 2022.During the procedure, the internal bolster detached.The procedure was completed with a new endovive securi-t replacement bolster.There were no patient complications reported as a result of this event.
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Manufacturer Narrative
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Block h2 (additional information): block d4 (lot number, expiration date) and block h4 (device manufacture date) have been updated based on the additional information received on december 7, 2022.Block h6 (device codes): device code a0501 captures the reportable event of internal bolster detached.
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Manufacturer Narrative
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Block h2 (additional information): block d4 (lot number, expiration date) and block h4 (device manufacture date) have been updated based on the additional information received on december 7, 2022.Block h6 (device codes): device code a0501captures the reportable event of internal bolster detached.Block h10: the returned endovive securi-t replacement bolster was analyzed.Upon visual assessment, it was observed that silicone tube of the bolster was detached.In addition, the inner ring mark on the bolster presumes that it was attached.Therefore, the complaint is confirmed.Based on the condition of the returned device, engineers determined that it is possible that at the time of interact with the device an excess of force has been applied; perhaps the manipulation, or technique used, could have contributed to this event.Boston scientific has determined the most probable cause of this complaint is adverse event related to procedure.
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Event Description
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It was reported to boston scientific corporation that an endovive securi-t replacement bolster was used during a percutaneous endoscopic gastrostomy replacement procedure on (b)(6) 2022.During the procedure, the internal bolster detached.The procedure was completed with a new endovive securi-t replacement bolster.There were no patient complications reported as a result of this event.
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Search Alerts/Recalls
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