inforMED
MalfunctionFFT

BRAVO

Received Jun 12, 2026 · Event occurred May 19, 2026

Report 9710107-2026-00286 · MDR key 25487688

Device

Generic name

Electrode, Ph, Stomach

Model number

FGS-0635

Catalog number

FGS-0635

Lot number

66428F

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 WAS SUCCESSFULLY ATTACHED TO THE PATIENT'S ESOPHAGUS BUT FAILED TO DETACH FROM THE DELIVERY DEVICE. THERE WAS NOTHING UNUSUAL ABOUT THE PATIENT OR THE PROCEDURE. THERE WAS NO PATIENT OR USER HARM. NO LUBRICATION WAS USED TO FACILITATE CAPSULE PLACEMENT.

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.