FDA Adverse Event
Malfunction
Summary report: N
OVERSTITCH NXT ENDOSCOPIC SUTURING SYSTEM
MDR report key: 19286510
·
Received May 10, 2024
Report
- Report Number
- 3005099803-2024-02060
- Event Type
- Malfunction
- Date Received
- May 10, 2024
- Date of Event
- April 15, 2024
- Report Date
- May 10, 2024
- Manufacturer
- APOLLO ENDOSURGERY
- Product Code
- OCW
- UDI-DI
- 10811955020893
- PMA / PMN Number
- K231553
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
BLOCK H6: DEVICE CODE A1702 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF DEVICE-DEVICE INCOMPATIBLE.
Description of Event or Problem · 0
IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT ON APRIL 16, 2024 THAT THE OVERTUBE AND NXT SYSTEM WOULD NOT FIT TOGETHER. ON (B)(6) 2024 THE PHYSICIAN REPORT WHEN TRYING TO INTUBATE WITH THE SCOPE AFTER RE-TAPING THE DEVICE TO THE SCOPE AND ADDING ADDITIONAL LUBRICATION, THAT THE SCOPE AND NXT WOULD NOT FIT THROUGH THE OVERTUBE. THE PHYSICIAN TRIED MULTIPLE ATTEMPTS. THE PHYSICIAN REMOVED THE OVERTUBE AND THE PROCEDURE WAS COMPLETED WITH THE NXT DEVICE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AS A RESULT OF THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2122927 | OVERSTITCH NXT ENDOSCOPIC SUTURING SYSTEM | ENDOSCOPIC TISSUE APPROXIMATION DEVICE | OCW | APOLLO ENDOSURGERY | ESS-G02-NXT | 10811955020893 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |