inforMED
MalfunctionKNQ

CRE

Received Feb 17, 2015 · Event occurred Feb 4, 2015

Report 4593512 · MDR key 4593512

Device

Generic name

Esophageal Balloon Dilation Catheter

Model number

M00558380

Catalog number

M00558380

Lot number

17499541

Product problems

  • Sticking

Patient

72 YR

  • No Information

Narrative

Description of Event or Problem

CRE DISPOSABLE BALLOON DILATOR WAS STUCK IN ESOPHAGOGASTRODUODENOSCOPY (EGD) SCOPE AND COULD NOT BE REMOVED BY PHYSICIAN DURING EGD PROCEDURE. THE BALLOON WAS DEFLATED, AND THE SCOPE WAS NOT TORQUED HOWEVER THE BALLOON COULD NOT BE PULLED OUT OR ADVANCED IN EGD SCOPE. THE SCOPE WAS REMOVED, BALLOON CUT AND REMOVED FROM SCOPE. THE DILATOR AND PACKAGING WAS GIVEN TO THE ENDOSCOPY CLINICAL PARTNER.