inforMED
MalfunctionPID

ESOFLIP

Received Feb 13, 2025 · Event occurred Aug 30, 2023

Report 9681384-2025-00151 · MDR key 21381751

Device

Generic name

Esophageal Dilator Balloon With Or Without Ele

Model number

ES-330

Catalog number

ES-330

Lot number

21K0705JZ

Product problems

  • Device Difficult to Setup or Prepare
  • Device Difficult to Program or Calibrate
  • Unable to Obtain Readings
  • Inadequacy of Device Shape and/or Size
  • Device Difficult to Setup or Prepare
  • Device Difficult to Program or Calibrate
  • Unable to Obtain Readings
  • Inadequacy of Device Shape and/or Size

Patient

NA · Unknown

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

Narrative

Description of Event or Problem

ACCORDING TO THE REPORTER, THE CATHETER FAILED TO PRE USE CHECK, CATHETER WAS INFLATED HOWEVER THE PURGE WAS NOT SHOWING ON THE SCREEN. THE DIAMETERS DID NOT CHANGE AND THE INFLATE/DEFLATE COULD NOT BE VISUALIZED ON THE SCREEN. THERE WAS NO PATIENT INVOLVED.

Additional Manufacturer Narrative

H3 - EVALUATION SUMMARY: FUNCTIONAL TESTING OF THE RETURN DEVICE CONFIRMED A MANUFACTURING FAULT. THE ROOT CAUSE OF THE OBSERVED CONDITION WAS DETERMINED TO BE A RESULT OF A MANUFACTURING ACTIVITY. A PROCESS IMPROVEMENT HAS BEEN INITIATED TO PREVENT THIS CONDITION FROM RECURRING. A REVIEW OF THE DEVICE HISTORY RECORD INDICATES THE PRODUCT WAS RELEASED MEETING ALL MEDTRONIC QUALITY RELEASE SPECIFICATIONS AT THE TIME OF MANUFACTURE. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Remedial action

  • Recall