inforMED
MalfunctionPLL

ORISE¿ GEL

Received Aug 15, 2022 · Event occurred Jul 28, 2022

Report 15224473 · MDR key 15224473

Device

Generic name

Submucosal Injection Agent

Model number

M00519220

Catalog number

M00519220

Lot number

28984525

Product problems

  • Break
  • Insufficient Flow or Under Infusion

Patient

23360 DA · Male

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

Narrative

Description of Event or Problem

WHILE USING THE ORISE GEL DURING THE ENDOSCOPY, THE GLASS SYRINGE BROKE IN MY HAND. IT HAD ABOUT 3 CC LEFT TO USE WHICH WE WOULD HAVE USED HAD THE SYRINGE NOT BROKEN.