inforMED
MalfunctionFFT

BRAVO

Received Apr 24, 2026 · Event occurred Apr 1, 2026

Report 9710107-2026-00160 · MDR key 24980871

Device

Generic name

Electrode, Ph, Stomach

Model number

FGS-0635

Catalog number

FGS-0635

Lot number

68245F

Product problems

  • Separation Failure

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE CAPSULE FAILED TO DETACH FROM THE DELIVERY DEVICE. THE PHYSICIAN BROKE THE HANDLE, AND THE CAPSULE REMAINED ATTACHED TO THE DEVICE WHEN IT WAS REMOVED FROM THE PATIENT.

Additional Manufacturer Narrative

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. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.