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UNIFIX ANORECTAL BALLOON HOLDER

Received Nov 14, 2013 · Event occurred Oct 15, 2013

Report 2023374-2013-00001 · MDR key 3535776

Device

Generic name

Unifix Anorectal Balloon Holder

Model number

A86-4400-10

Catalog number

A86-4400-10

Lot number

NA

Product problems

  • Detachment Of Device Component

Patient

Not reported

  • No Code Available

Narrative

Description of Event or Problem

THE BAND HOLDER DID NOT HOLD THE BALLOON ON THE ANORECTAL PROBE WHEN THE PROBE WAS REMOVED. THE BALLOON WAS LOST WITHIN THE PATIENT'S COLON. A SIGMOIDOSCOPY WAS PERFORMED TO REMOVE THE BALLOON.

Remedial action

  • Other