FDA Adverse Event Injury Summary report: N

ENDO-THERAPEUTICS SINGLE-USE LARGE OVAL SNARE

MDR report key: 1023406 · Received March 31, 2008

Report

Report Number
1056129-2008-00001
Event Type
Injury
Date Received
March 31, 2008
Date of Event
February 27, 2008
Report Date
March 29, 2008
Manufacturer
ENDO-THERAPEUTICS, INC.
Product Code
FDI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SD, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION AND DESIGN REVIEW ATTEMPTED TO DUPLICATE/IDENTIFY ANY POTENTIAL CAUSE AND WAS UNABLE TO DETERMINE CAUSE. MANUFACTURER HAS HAD NO OTHER REPORTS OF SIMILAR EVENT.

Description of Event or Problem · 1

USER FACILITY REPORTED THAT A BOWEL PERFORATION WAS DISCOVERED DURING POST-OPERATIVE CARE OF A COLONOSCOPY PATIENT. PHYSICIAN DID NOT BELIEVE THE DEVICE WAS DEFECTIVE, HOWEVER, ATTRIBUTED THE PENETRATION TO A SHARP TIP ON THE SNARE. THE DEVICE WAS DISCARDED AND WAS NOT RETURNED TO THE MANUFACTURER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDO-THERAPEUTICS SINGLE-USE LARGE OVAL SNARE SNARE, NON-ELECTRICAL FDI ENDO-THERAPEUTICS, INC. SGO-1622L

Patients

Seq Age Sex Outcome Treatment
1 69 YR Hospitalization STANDARD ENDOSCOPE - NO OTHER DETAILS PROVIDED| BY USER FACILITY.