BRAVO
Received Jun 11, 2026 · Event occurred May 18, 2026
Report 9710107-2026-00283 · MDR key 25477645
Device
Generic name
Electrode, Ph, Stomach
Manufacturer
Given Imaging Ltd., YoqneamModel number
FGS-0635Catalog number
FGS-0635
Lot number
68485F
Product problems
- Separation Failure
Patient
NA · Unknown
- Airway Obstruction
- Laceration(s) of Esophagus
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. THE CAPSULE WAS LOCATED IN THE MOUTH AFTER THE FAILURE TO ATTACH AND WAS RETRIEVED FROM THE PATIENT USING FORCEPS AND A SLIGHT TEAR OF THE ESOPHAGUS WAS REPORTED. LUBRICANT WAS USED AND WAS REPORTED TO HAVE BEEN CAREFULLY APPLIED TO AVOID COVERING THE SUCTION CHAMBER. THE PATIENT WAS STABLE.