inforMED
MalfunctionKAM

RELIEVA FLEX SINUS GUIDE CATHETER

Received Aug 14, 2014 · Event occurred Jul 17, 2014

Report 3005172759-2014-00020 · MDR key 4066676

Device

Generic name

Flex Guide Catheter

Manufacturer

Acclarent

Model number

NA

Catalog number

GC110RF

Lot number

130403E-CM

Product problems

  • Material Fragmentation

Patient

UNK

  • Foreign Body In Patient

Narrative

Description of Event or Problem

IT WAS REPORTED THAT AFTER DILATING THE RIGHT MAXILLARY SINUS THE PHYSICIAN WAS ABOUT TO INSERT THE DEVICE INTO THE LEFT MAXILLARY SINUS WHEN IT WAS OBSERVED THAT THE BLUE TIP OF THE SINUS GUIDE CATHETER WAS MISSING. THE PHYSICIAN EXAMINED THE RIGHT MAXILLARY SINUS. THE USER REPORTED THAT THE TIP WAS LOCATED INSIDE A BLOOD CLOT THAT HAD ALREADY BEEN REMOVED FROM THE PT EARLIER IN THE SAME PROCEDURE. THE GUIDE WAS REPLACED AND THE PROCEDURE WAS SUCCESSFULLY COMPLETED.

Additional Manufacturer Narrative

THE DEVICE REFERENCED IS BEING RETURNED FOR EVAL. REVIEW OF MFG RECORDS ASSOCIATED WITH THE SUBJECT DEVICE DID NOT DETECT ANY ANOMALIES. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WITH THE RESULTS OF THE EVAL FOLLOWING RECEIPT OF THE DEVICE. ACCLARENT WILL CONTINUE TO MONITOR THIS PHENOMENON FOR TRENDING PURPOSES.

Remedial action

  • Other