inforMED
InjuryNSI

P/CAM PATENCY CAPL 1-PK

Received Nov 17, 2015

Report 9710107-2015-05036 · MDR key 5230969

Device

Generic name

System, Imaging, Esophageal, Wireless, Capsule

Manufacturer

Given Ltd (israel)

Model number

FGS-0109

Catalog number

FGS-0109

Product problems

  • Adverse Event Without Identified Device or Use Problem

Patient

Not reported

  • Abdominal Pain

Narrative

Additional Manufacturer Narrative

(B)(4).

Additional Manufacturer Narrative

(B)(4) INITIAL REPORT DATE: 11/17/2015. TO DATE THE INCIDENT SAMPLE HAS NOT BEEN RECEIVED FOR EVALUATION. IF THE SAMPLE IS RECEIVED OR IF ADDITIONAL INFORMATION PERTINENT TO THE INCIDENT IS OBTAINED A FOLLOW-UP REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem

CUSTOMER REPORTED PATIENT EXPERIENCING ABDOMINAL PAIN AFTER TAKING PATENCY CAPSULE. PHYSICIAN IS NOT CERTAIN IF THE CAPSULE HAS PASSED. PHYSICIAN PLANS TO CONDUCT A CT SCAN TO DETERMINE IF THE PATENCY CAPSULE IS RESIDING IN THE DESCENDING COLON. PREVIOUS CT SCANS WERE NORMAL SHOWING NO STRICTURES. THIS IS BEING REPORTED OUT OF AN ABUNDANCE OF CAUTION.