inforMED
InjuryPTS

SPYGLASS RETRIEVAL BASKET

Received Jul 6, 2023 · Event occurred Jun 9, 2023

Report 3005099803-2023-03468 · MDR key 17273744

Device

Generic name

Endoscopic Grasping/cutting Instrument, Non-powered

Model number

M00546550

Catalog number

UNK

Lot number

0028792389

Product problems

  • Detachment of Device or Device Component
  • Detachment of Device or Device Component

Patient

Unknown

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

Narrative

Description of Event or Problem

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A SPYBASKET WAS USED IN THE COMMON BILE DUCT DURING AN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) PROCEDURE PERFORMED ON (B)(6) 2023. DURING THE PROCEDURE, THE BASKET DETACHED INTO THE PATIENT'S COMMON BILE DUCT. THE DETACHED BASKET WAS RETRIEVED USING A RESCUE FORCEPS AND THE PROCEDURE WAS COMPLETED WITH ANOTHER SPYBASKET. THERE WERE NO PATIENT COMPLICATIONS AS A RESULT OF THIS EVENT.

Additional Manufacturer Narrative

BLOCK E1: (B)(6). BLOCK H6: IMDRF DEVICE CODE A0501 CAPTURES THE REPORTABLE EVENT OF BASKET DETACHED. IMDRF IMPACT CODE F2301 IS BEING USED FOR THE REPORTABLE EVENT OF RESCUE FORCEPS USED TO RETRIEVE THE BASKET.