inforMED
MalfunctionPID

RIGIFLEX II

Received Aug 5, 2021 · Event occurred Jul 14, 2021

Report 3005099803-2021-04006 · MDR key 12284141

Device

Generic name

Dilator, Esophageal

Model number

M00554510

Catalog number

5451

Product problems

  • Inflation Problem
  • Appropriate Device Problem Term/Code Not Available
  • Inflation Problem
  • Appropriate Device Problem Term/Code Not Available

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

THE COMPLAINANT WAS UNABLE TO PROVIDE THE LOT NUMBER. THEREFORE, THE MANUFACTURE AND EXPIRATION DATES ARE UNKNOWN. (B)(4). ACCORDING TO THE COMPLAINANT, THE SUSPECT DEVICE HAS BEEN DISPOSED AND IS NOT AVAILABLE FOR RETURN. IF ANY FURTHER RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL MDR WILL BE FILED.

Description of Event or Problem

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A RIGIFLEX II DILATATION BALLOON WAS USED IN THE ESOPHAGUS DURING AN ACHALASIA DILATION PROCEDURE PERFORMED ON (B)(6) 2021. DURING THE PROCEDURE, IT WAS NOTED THAT THE BALLOON DID NOT INFLATE. THE PROCEDURE WAS RESCHEDULED AT THIS TIME. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.