inforMED
InjuryFFT

BRAVO

Received Jun 11, 2026 · Event occurred May 18, 2026

Report 9710107-2026-00283 · MDR key 25477645

Device

Generic name

Electrode, Ph, Stomach

Model number

FGS-0635

Catalog 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.