inforMED
InjuryFCE

SET,BUCKET,ENEMA

Received Jan 8, 2019 · Event occurred Feb 8, 2018

Report 1417592-2018-00150 · MDR key 8226845

Device

Generic name

Set,bucket,enema

Catalog number

DYND70104H

Lot number

UNK

Product problems

  • Contamination of Device Ingredient or Reagent

Patient

66 YR

  • Foreign Body In Patient
  • Foreign Body In Patient

Narrative

Additional Manufacturer Narrative

MANUFACTURER WAS NOTIFIED VIA MEDWATCH ((B)(4)) OF AN INCIDENT THAT OCCURRED AT AN END-USER FACILITY. IT WAS REPORTED THAT THE PATIENT WAS UNDERGOING AN EXPLORATORY LAPAROTOMY ON (B)(6) 2018 DUE TO A BOWEL OBSTRUCTION WHEN TWO ENEMA CAPS WERE NOTICED INSIDE THE PATIENT. THE FACILITY REPORTED THAT THE PATIENT RECEIVED TWO ENEMAS ON (B)(6) 2018. ONE ENEMA WAS REPORTEDLY GIVEN BY A FACILITY NURSE AND ONE ENEMA GIVEN BY A STUDENT NURSE/INSTRUCTOR. THE FACILITY REPORTED THAT THE CAPS WERE NOT NOTICED AS MISSING DURING EITHER OF THE ENEMA ADMINISTRATIONS SO THE FACILITY IS UNSURE OF THE ACTUAL EVENT DATE THAT RESULTED IN THE ENEMA CAPS BEING LEFT INSIDE THE PATIENT. THERE WAS NO ADDITIONAL MEDICAL INTERVENTION REPORTED AND THE PATIENT IS REPORTEDLY DOING WELL. A SAMPLE IS NOT AVAILABLE TO BE RETURNED FOR EVALUATION AND A ROOT CAUSE COULD NOT BE DETERMINED. DUE TO THE REPORTED INCIDENT, AND IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ADDITIONAL RELEVANT INFORMATION BECOMES AVAILABLE A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Description of Event or Problem

IT WAS REPORTED THAT A PATIENT WAS UNDERGOING AN EXPLORATORY LAPAROTOMY DUE TO A BOWEL OBSTRUCTION WHEN TWO ENEMA CAPS WERE NOTICED INSIDE THE PATIENT FROM A PREVIOUS ENEMA AND REMOVED.