inforMED
MalfunctionFFT

BRAVO

Received Jun 2, 2026 · Event occurred May 8, 2026

Report 9710107-2026-00261 · MDR key 25361149

Device

Generic name

Electrode, Ph, Stomach

Model number

FGS-0635

Catalog number

FGS-0635

Lot number

66831F

Product problems

  • Separation Failure

Patient

36 YR · Female

  • No Clinical Signs, Symptoms or Conditions

Narrative

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.

Description of Event or Problem

IT WAS REPORTED THAT THE CAPSULE FAILED TO ATTACH TO THE PATIENT¿S ESOPHAGUS AND STILL ATTACHED TO THE DELIVERY SYSTEM UPON REMOVAL. THERE WAS NO PATIENT AND USER HARM. LUBRICATION WAS USED TO FACILITATE THE PLACEMENT OF THE CAPSULE.