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Model Number M00562402 |
Device Problems
Electrical /Electronic Property Problem (1198); Failure to Cut (2587); Adverse Event Without Identified Device or Use Problem (2993)
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Patient Problems
Burn(s) (1757); Perforation (2001); No Code Available (3191)
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Event Date 06/26/2020 |
Event Type
Injury
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Manufacturer Narrative
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(b)(4).The device has not been received for analysis.Upon receipt and completion of the failure analysis of the complaint device, if there is any further relevant information from that review, a supplemental medwatch will be filed.
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Event Description
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It was reported to boston scientific corporation that a captiflex medium oval flexible snare was used during a colonoscopy procedure performed on (b)(6) 2020.According to the complainant, during the procedure, the device failed to cut the target polyp using cautery.Reportedly, the physician had to "over burn" to remove the polyp which caused a transmural burn.The original device was used to complete the colonoscopy procedure.On (b)(6) 2020, it was confirmed through computerised tomography scan (ct scan) that the patient had a micro perforation.An ostomy bag was inserted as a result of irritation from the micro-perforation.It is expected that the ostomy bag will be reversed after 3 months.Reportedly, the patient had no comorbidities.The patient was admitted to the hospital for at least a week and is expected to fully recover.
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Event Description
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It was reported to boston scientific corporation that a captiflex medium oval flexible snare was used during a colonoscopy procedure performed on (b)(6) 2020.According to the complainant, during the procedure, the device failed to cut the target polyp using cautery.Reportedly, the physician had to "over burn" to remove the polyp which caused a transmural burn.The original device was used to complete the colonoscopy procedure.On (b)(6) 2020, it was confirmed through computerised tomography scan (ct scan) that the patient had a micro perforation.An ostomy bag was inserted as a result of irritation from the micro-perforation.It is expected that the ostomy bag will be reversed after 3 months.Reportedly, the patient had no comorbidities.The patient was admitted to the hospital for at least a week and is expected to fully recover.
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Manufacturer Narrative
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Block h6: problem code 2587 captures the reportable event of snare loop failure to cut.Problem code 1198 captures the reportable event of suboptimal cautery.Problem code 2001 captures the reportable event of perforation.Problem code 1757 captures the reportable event of burns.Problem code 3191 captures the reportable event of ostomy procedure.Conclusion code 4316 is being used in lieu of an adequate conclusion code for "device not returned." block h10: the device has not been received for analysis.Upon receipt and completion of the failure analysis of the complaint device, if there is any further relevant information from that review, a supplemental medwatch will be filed.Block h11: blocks h2, h6 and h10 have been updated based on the investigation closure for device not returned.Correction: sections h7 and h9.
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Search Alerts/Recalls
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