inforMED
MalfunctionKAM

RELIEVA FLEX SINUS GUIDE CATHETER

Received Dec 18, 2013 · Event occurred Nov 25, 2013

Report 3005172759-2013-00040 · MDR key 3724594

Device

Generic name

Flex Guide Catheter

Manufacturer

Acclarent

Model number

NA

Catalog number

CG110RF

Lot number

130318F-CM

Product problems

  • Detachment Of Device Component

Patient

UNK

  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

THE PHYSICIAN STATED THAT THERE WAS NO PATIENT INJURY AND THE TIP WAS REMOVED EASILY BY FORCEPS. THE SUBJECT DEVICE OF THIS REPORT WAS NOT RETURNED FOR EVALUATION, AND ITS WHEREABOUTS ARE UNKNOWN. ACCLARENT WILL CONTINUE TO MONITOR THIS PHENOMENON FOR TRENDING PURPOSES. THIS REPORT IS BEING SUBMITTED IN AN ABUNDANCE OF CAUTION.

Description of Event or Problem

ACCLARENT WAS NOTIFIED ON (B)(6) 2013 OF AN EVENT DURING A SINUS SURGICAL CASE WHEN ACCLARENT BALLOON DILATION TECHNOLOGY WAS USED. THE PHYSICIAN TRIED TO ACCESS THE RIGHT MAXILLARY SINUS AND THE BLUE TIP OF THE GUIDE CATHETER CAME OFF IN THE MIDDLE MEATUS. THE PHYSICIAN WAS ABLE TO RETRIEVE THE TIP ENDOSCOPICALLY.

Remedial action

  • Other