OVERSTITCH ENDOSCOPIC SUTURE SYSTEM
Report
- Report Number
- 3005099803-2025-06117
- Event Type
- Injury
- Date Received
- November 21, 2025
- Date of Event
- October 17, 2025
- Report Date
- November 21, 2025
- Manufacturer
- APOLLO ENDOSURGERY
- Product Code
- OCW
- UDI-DI
- 20811955020661
- PMA / PMN Number
- K181141
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
BLOCK H6 DEVICE CODE A040609 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF NEEDLE SHAFT BENT. IMDRF CODE F2301 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF ADDITIONAL DEVICE REQUIRED. IMDRF CODE F1901 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF ADDITIONAL SURGERY.
IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT AN OVERSTITCH ENDOSCOPIC SUTURE SYSTEM WAS USED DURING A FISTULA REPAIR ON (B)(6) 2025. DURING THE PROCEDURE, THE NEEDLE SHAFT WAS BENT. UPON REMOVAL OF THE FIRST OVERSTITCH DEVICE, IT WAS OBSERVED THERE WAS TISSUE DAMAGE TO THE ESOPHAGUS, WHICH CAUSED MAJOR BLEEDING. THE BLEEDING WAS TREATED WITH PURASTAT. AN ATTEMPT WAS MADE TO COMPLETE THE PROCEDURE WITH A SECOND OVERSTITCH DEVICE, WHICH WAS ALSO BENT. THE SECOND OVERSTITCH DEVICE DID NOT CAUSE ANY COMPLICATIONS. THE PHYSICIAN ATTEMPTED TO CLOSE THE FISTULA USING CLIPS. HOWEVER, THE CLIPS WERE NOT SUCCESSFUL. THE PATIENT HAD AN ADDITIONAL SURGERY TO SUCCESSFULLY CLOSE THE FISTULA. THE PATIENT HAS MADE A FULL RECOVERY. THIS REPORT IS RELATED TO THE SECOND OF TWO OVERSTITCH DEVICES AND TWO OVERSTITCH SUTURES USED IN THE SAME PROCEDURE. PLEASE REFER TO REPORTS 3005099803-2025-06116 FOR THE FIRST OVERSTITCH DEVICE, 3005099803-2025-06280 FOR THE FIRST OVERSTITCH SUTURE, AND 3005099803-2025-06281 FOR THE SECOND OVERSTITCH SUTURE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2462801 | OVERSTITCH ENDOSCOPIC SUTURE SYSTEM | ENDOSCOPIC TISSUE APPROXIMATION DEVICE | OCW | APOLLO ENDOSURGERY | ESS-G02-160 | 20811955020661 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Required Intervention |