RELIEVA STRATUS MICROFLOW SPACER
Received Apr 25, 2013 · Event occurred Mar 28, 2013
Report 3005172759-2013-00017 · MDR key 3085133
Device
Generic name
Ethmoid Microflow Spacer
Manufacturer
Acclarent, Inc.Model number
NACatalog number
BC1017RS
Lot number
UNK
Product problems
- Device Operates Differently Than Expected
Patient
35 YR
- Pain
Narrative
Description of Event or Problem
ACCLARENT WAS NOTIFIED ON (B)(6) 2013 OF AN EVENT OCCURRED ON (B)(6) 2013 DURING A SINUS SURGICAL CASE WHEN ACCLARENT BALLOON DILATION TECHNOLOGY WERE USED. THE TREATING SURGEON REPORTED THAT IN (B)(6) 2010, A COLLEAGUE OF HIS, INSERTED AN ACCLARENT ETHMOID SINUS STRATUS SPACER ON THE RIGHT SIDE OF ETHMOID SINUS. THERE WERE NO DIFFICULTIES REPORTED AND HE WAS UNAWARE OF THE INSERTION. THE PT RECENTLY WENT TO EMERGENCY ROOM COMPLAINING OF RIGHT FOREHEAD PAIN. THE TREATING SURGEON OBTAINED A CT SCAN THAT REVEALED THE SPACER MOSTLY IN THE ETHMOID SINUS, BUT PARTIALLY IN THE RIGHT MAXILLARY SINUS. THE TREATING SURGEON AND THE PT DECIDED TO REMOVE THE SPACER AND DILATE THE RIGHT FRONTAL SINUS UNDER ANESTHESIA ON (B)(6) 2013. THE ENTIRE ACCLARENT ETHMOID STRATUS SPACER WAS ABLE TO BE REMOVED INTACT AND NO FURTHER REPORTED SEQUELAE.
Additional Manufacturer Narrative
ACCLARENT FOLLOWED UP ON THIS REPORT TO GATHER ADD'L INFO. TREATING SURGEON MENTIONED THAT THE SPACER HAD FUNCTIONED PROPERLY HAVING RESOLVED THE INITIAL SINUS PATHOLOGY. PER INSTRUCTION FOR USE, THE ACCLARENT STRATUS DEVICES ARE APPROVED FOR IMPLANTATION FOR A 14 DAYS PERIOD. VP OF MEDICAL AFFAIRS CONCLUDED THAT THE LONG PERIOD OF IMPLANTATION OF ETHMOID SINUS SPACER MAY HAVE CONTRIBUTED TO THE FOREHEAD PAIN. THE SUBJECT DEVICE OF THIS REPORT WAS NOT RETURNED FOR EVAL, AND ITS WHEREABOUTS ARE UNK. ACCLARENT WILL CONTINUE TO MONITOR THIS PHENOMENON FOR TRENDING PURPOSES.
Remedial action
- Other