The patient was here for egd with bravo ph capsule placement.During procedure the doctor attempted to place the bravo capsule at 29 cm in the esophagus.Following the sixty second vacuum application, the doctor broke suction before deploying the device.Another sixty seconds of suction was applied then the device was deployed followed by the standard discontinuation of suction and twisting motion to free the device.When the delivery device was removed from the mouth the probe was still sitting on it loosely.With the thought process that the interruption of suction initially may have caused this, another bravo probe from the same box and lot was used.This time all suction, deployment, discontinuation of suction and twisting was performed appropriately and without difficulty by the doctor.Upon examination of the capsule with the edg scope, the capsule was found to be in the esophagus, but not secured to the mucosal wall.The device was retrieved and a third capsule; one from a brand new box with a different lot number was tried.This time the doctor performed all steps of deployment as they should have been.When he attempted to twist the deployment device off, he noticed a slight resistance.Instructions on the handle tell you how to break the handle to complete deployment if resistance is met.Again, the doctor performed these steps appropriately.When the edg scope was placed to confirm the capsules location, it was not found in the esophagus.When backing the scope out, the capsule was found resting in the oropharynx.Several attempts were made to remove it, and finally this was accomplished with a glidescope and mcgills forceps.
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