inforMED
InjuryNSI

PILLCAM

Received Jun 28, 2019 · Event occurred Mar 27, 2019

Report 9710107-2019-00298 · MDR key 8746659

Device

Generic name

System, Imaging, Esophageal, Wireless, Capsule

Model number

FGS-0109

Catalog number

FGS-0109

Lot number

45103

Product problems

  • Entrapment of Device
  • Entrapment of Device

Patient

34 YR

  • Foreign Body In Patient
  • Foreign Body In Patient

Narrative

Additional Manufacturer Narrative

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem

ACCORDING TO THE REPORTER, THE CAPSULED FAILED TO DISSOLVE AND THE PATIENT EXPERIENCED GASTROINTESTINAL PROBLEMS DUE TO THIS FAILURE, SO AN OPERATION WAS REQUIRED TO REMOVE THE CAPSULE WHICH ALSO REQUIRED AN EXTENDED HOSPITALIZATION OF OVER ONE WEEK. THE CAPSULE WAS INGESTED AND REMOVED. A REPEAT PROCEDURE WAS NOT NECESSARY.