inforMED
MalfunctionFTT

BRAVO

Received Nov 10, 2017 · Event occurred Apr 20, 2016

Report 9710107-2017-05610 · MDR key 7018907

Device

Generic name

Camera, Still, Surgical

Model number

FGS-0312

Catalog number

FGS-0312

Lot number

30496Q

Product problems

  • Premature Activation
  • Premature Activation

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

INVESTIGATION SUMMARY: THE INVESTIGATION IS BASED ON RAPID PH GRAPH REVIEW AND ON THE GRAPH IT APPEARS THAT THE PH LEVEL DROPS BELOW 4 PH AND THEN INCREASES TO 8 PH. DHR (DEVICE HISTORY RECORD): BRAVO CAPSULE, LOT: 30496Q, PASS. SINCE THERE ARE PH LEVEL SURGES ON THE GRAPH, IT CAN BE CONCLUDED THAT THE CAPSULE DETACHED EARLIER. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem

ACCORDING TO THE REPORTER, CUSTOMER CALLED TO REPORT A BRAVO CAPSULE EARLY DETACHMENT. PER TECH, REVIEWED STUDY SUBMITTED VIA EMAIL, TRACINGS INDICATE THE CAPSULE DETACHED SHORTLY AFTER IT WAS PLACED. A REPEAT PROCEDURE WAS NECESSARY.