FDA Adverse Event Other Summary report: N

SMARTPILL GI MONITORING SYSTEM, PHP CAPSULE

MDR report key: 1353986 · Received March 20, 2009

Report

Report Number
1320877-2009-00001
Event Type
Other
Date Received
March 20, 2009
Date of Event
February 25, 2009
Report Date
March 17, 2009
Manufacturer
THE SMARTPILL CORPORATION
Product Code
NYV
PMA / PMN Number
K053547
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

CAPSULE MOTILITY PROCEDURE ORDERED FOR PT BECAUSE OF PRESENTING SYMPTOMS OF GASTROPARESIS - EARLY SATIETY, BLOATING, BELCHING. CAPSULE INGESTED ON (B)(6)2009. ON (B)(6)2009, PT COMPLAINED OF ABDOMINAL PAIN AND CRAMPING. PHYSICIAN DETERMINED CAPSULE BECAME LODGED IN THE SMALL INTESTINE "LEVEL WITH THE ILLEUM." PT HOSPITALIZED AND GIVEN IV FLUIDS, NG TUBE, BED REST. OBSTRUCTION RESOLVED WITHIN 48 HRS. PT DISCHARGED, DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMARTPILL GI MONITORING SYSTEM, PHP CAPSULE NYV THE SMARTPILL CORPORATION

Patients

Seq Age Sex Outcome Treatment
1 72 YR Hospitalization