FDA Adverse Event Injury Summary report: N

BIOPROTECT BALLOON IMPLANT¿ SYSTEM

MDR report key: 20840720 · Received December 4, 2024

Report

Report Number
3014285231-2024-00006
Event Type
Injury
Date Received
December 4, 2024
Date of Event
November 5, 2024
Report Date
December 4, 2024
Manufacturer
BIOPROTECT LTD.
Product Code
OVB
PMA / PMN Number
K222972
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Description of Event or Problem · 0

IT WAS REPORTED TO BIOPROTECT LTD. ON (B)(6) 2024 THAT THE BIOPROTECT BALLOON IMPLANT SYSTEM WAS IMPLANTED DURING PROCEDURE PERFORMED ON (B)(6) 2024. REPORTEDLY, THE PROCEDURE WAS DONE UNDER LOCAL ANESTHESIA. AFTER PROCEDURE COMPLETION AND DURING THE FINAL DIGITAL RECTAL EXAM (DRE), A RECTAL PERFORATION WAS IDENTIFIED, AND THE BALLOON WAS REMOVED TRANSRECTALLY WITH MINIMAL BLOOD LOSS OF ABOUT 30 CC PR. THE PATIENT WAS DIAGNOSED WITH LINEAR LACERATION IN THE ANTERIOR ANORECTAL MUCOSA. THE PATIENT WAS ADMITTED FOR OBSERVATION AND IV ANTIBIOTICS AS A PRECAUTIONARY MEASURE, WITH A LIQUID DIET. THE PATIENT WAS DISCHARGED HOME ON (B)(6) 2024 AND REPORTED WITH NO SIGNS OF INFECTION, ACUTE ABDOMEN, FEVERS OR CHILLS, AND WITH ORAL FLAGYL WITH VERY GOOD PROGNOSIS FOR COMPLETE HEALING. THE PATIENT IS SCHEDULED FOR A FOLLOW-UP IN A FEW WEEKS FOR A POSSIBLE ANO-SCOPIC EXAMINATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2112986 BIOPROTECT BALLOON IMPLANT¿ SYSTEM ABSORBABLE PERIRECTAL SPACER OVB BIOPROTECT LTD. 5135

Patients

Seq Age Sex Outcome Treatment
1 69 YR Male Required Intervention