Model Number M00568151 |
Device Problem
Detachment of Device or Device Component (2907)
|
Patient Problem
No Clinical Signs, Symptoms or Conditions (4582)
|
Event Date 12/14/2022 |
Event Type
malfunction
|
Manufacturer Narrative
|
Device code a0501captures the reportable event of internal bolster detached.
|
|
Event Description
|
It was reported to boston scientific corporation that an endovive securi-t was used during a gastrostomy replacement procedure performed on (b)(6) 2022.During the procedure, while removing the device that was placed back on (b)(6) 2022 it separated.The bolster dislodged in the stomach.There was no removal attempt to get the bolster as the physician felt it would pass naturally.The procedure was completed with another of the same device.There were no patient complications reported as a result of this event.
|
|
Manufacturer Narrative
|
Block h6 (device codes): device code a0501captures the reportable event of internal bolster detached.Block h10: an endovive securi-t percutaneous replacement bolster was returned.Visual analysis of the device revealed the tube was without internal bolster and was not returned.Media inspection showed the internal bolster detached and has remnants of use.Therefore, the reported complaint is confirmed.Based on the condition of the returned device, engineers determined that the problem observed could be related to the manipulation or anatomical conditions of the patient could have contributed to the separation.Boston scientific has determined the most probable cause of this complaint is adverse event related to procedure.It is most likely that the adverse event occurred during the procedure and the device had no influence on event which led to the reported event.
|
|
Event Description
|
It was reported to boston scientific corporation that an endovive securi-t was used during a gastrostomy replacement procedure performed on (b)(6) 2022.During the procedure, while removing the device that was placed back on (b)(6) 2022 it separated.The bolster dislodged in the stomach.There was no removal attempt to get the bolster as the physician felt it would pass naturally.The procedure was completed with another of the same device.There were no patient complications reported as a result of this event.
|
|
Search Alerts/Recalls
|