BRAVO
Received Apr 28, 2026 · Event occurred Apr 3, 2026
Report 9710107-2026-00171 · MDR key 25017463
Device
Generic name
Electrode, Ph, Stomach
Manufacturer
Given Imaging Ltd., YoqneamModel number
FGS-0635Catalog number
FGS-0635
Lot number
67841F
Product problems
- Positioning Failure
Patient
NA · Unknown
- Airway Obstruction
Narrative
Description of Event or Problem
IT WAS REPORTED THAT THE CAPSULE FAILED TO ATTACH TO THE PATIENT¿S ESOPHAGUS AS THE HANDLE BROKE. THE CAPSULE WAS THEN REPORTED AS LOST WITH ITS LOCATION INITIALLY UNKNOWN. THE PATIENT WAS ROLLED AND THE CAPSULE WAS PULLED OUT OF THE PATIENT¿S MOUTH. THERE WAS NO PATIENT OR USER HARM.
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. 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.