FDA Adverse Event Injury Summary report: N

DISPOSABLE DISTAL ATTACHMENT

MDR report key: 10044747 · Received May 11, 2020

Report

Report Number
8010047-2020-02606
Event Type
Injury
Date Received
May 11, 2020
Report Date
October 22, 2020
Manufacturer
OLYMPUS MEDICAL SYSTEMS CORP.
Product Code
FDS
PMA / PMN Number
K984358
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING SUPPLEMENTED TO PROVIDE THE LEGAL MANUFACTURER¿S INVESTIGATION SUMMARY REGARDING THIS REPORT. THE LEGAL MANUFACTURER FURTHER REVIEWED THE LITERATURE AND SINCE THERE WERE NO REPORTED DEFECTS OR MALFUNCTION ON THE OLYMPUS¿ DEVICES ALLEGED, IT IS PRESUMED THAT THE REPORTED ADVERSE EVENTS WERE NOT RELATED TO PRODUCT DEFECTS/MALFUNCTIONS. THE CONCLUSIVE CAUSE OF THE PATIENT¿S EXPERIENCE CANNOT BE DETERMINED. CROSS REFERENCE RELATED REPORTS: 2951238-2020-00439, 2951238-2020-00438, 2951238-2020-00437.

Additional Manufacturer Narrative · 1

THE DEVICE HISTORY COULD NOT BE PERFORMED AS THE ARTICLE DID NOT SPECIFY THE MODEL NUMBER OR LOT NUMBER OF THE REFERENCED TRANSLUCENT CAP. THEREFORE, THE EXACT CAUSE OF THE USER'S EXPERIENCE AND THE REPORTED PHENOMENON COULD NOT BE DETERMINED. PODBOY, A., KOLAHI, S., FRIEDLAND, S. & LOUIE, C. (2020). ENDOSCOPIC SUBMUCOSAL DISSECTION IS ASSOCIATED WITH LESS PATHOLOGIC UNCERTAINTY THAN ENDOSCOPIC MUCOSAL RESECTION IN DIAGNOSING AND STAGING BARRETT¿S-RELATED NEOPLASIA. DIGESTIVE ENDOSCOPY, 32, 346-354. HTTPS://DOI.ORG/10.1111/DEN.13487. THIS EVENT HAS BEEN REPORTED BY THE IMPORTER ON MDR# 2951238-2020-00440. DEVICE NOT RETURNED.

Description of Event or Problem · 1

OLYMPUS MEDICAL SYSTEMS CORP. (OMSC) RECEIVED A JOURNAL ARTICLE TITLED "ENDOSCOPIC SUBMUCOSAL DISSECTION IS ASSOCIATED WITH LESS PATHOLOGIC UNCERTAINTY THAN ENDOSCOPIC MUCOSAL RESECTION IN DIAGNOSING AND STAGING BARRETT¿S-RELATED NEOPLASIA." THE DOCUMENTED STUDY REVIEWED THE DIFFERENCE IN THE REMOVAL OF ESOPHAGEAL LESIONS VIA ENDOSCOPIC MUCOSAL RESECTION (EMR) AND ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD), PATHOLOGICAL SPECIMEN AND CLINICAL DECISION-MAKING AND THE SECONDARY EVALUATION OF THE EFFECT ON THE OUTCOME OF THE PATIENT. DURING THE STUDY, IT WAS REPORTED THAT DELAYED ESOPHAGEAL STRICTURES DEVELOPED IN FOUR OF THE PATIENTS, ONE IN THE EMR GROUP AND THREE IN THE ESD GROUP. IN ALL FOUR PATIENTS, THEY REQUIRED ENDOSCOPIC DILATATION. THERE WAS NO ADDITIONAL INFORMATION AVAILABLE. THIS COMPLAINT WILL CAPTURE 3 OF 3 PATIENTS IN THE ESD GROUP USING TRANSLUCENT CAP UNKNOWN MODEL NUMBER D-201.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
508603 DISPOSABLE DISTAL ATTACHMENT GASTROSCOPE AND ACCESSORIES, FLEXIBLE/RIGID FDS OLYMPUS MEDICAL SYSTEMS CORP. UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention