SPACEOAR VUE SYSTEM
Report
- Report Number
- 2124215-2025-90653
- Event Type
- Injury
- Date Received
- December 12, 2025
- Date of Event
- October 28, 2025
- Report Date
- January 8, 2026
- Manufacturer
- BOSTON SCIENTIFIC CORPORATION
- Product Code
- OVB
- UDI-DI
- 00850009803009
- PMA / PMN Number
- K182971
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AS
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
DETAILED PRODUCT INFORMATION WAS NOT PROVIDED TO BSC. WE COMPLETED A GOOD FAITH EFFORT TO OBTAIN THE INFORMATION. BECAUSE THE PRODUCT IS UNKNOWN AT THIS TIME, WE ARE UNABLE TO PROVIDE THE COMPLETED UDI AND OTHER PRODUCT SPECIFIC INFORMATION. IF ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. BLOCKS D4 AND H4: THE COMPLAINANT WAS UNABLE TO REPORT THE LOT NUMBER; THEREFORE, THE MANUFACTURE DATE AND EXPIRATION DATE ARE UNKNOWN. BLOCK H6: IMDRF DEVICE CODE A150202 CAPTURES THE REPORTABLE EVENT OF GEL MISPLACEMENT NON-VASCULAR. IMDRF PATIENT CODE E0506 CAPTURES THE REPORTABLE EVENT OF BLEEDING. IMDRF PATIENT CODE E2330 CAPTURES THE REPORTABLE EVENT OF PAIN. IMDRF PATIENT CODE E232401 CAPTURES THE REPORTABLE EVENT OF FECAL INCONTINENCE. IMDRF PATIENT CODE E2311 CAPTURES THE REPORTABLE EVENT OF DISCOMFORT. IMDRF PATIENT CODE E2315 CAPTURES THE REPORTABLE EVENT OF FLUID DISCHARGE. IMDRF PATIENT CODE E2339 CAPTURES THE REPORTABLE EVENT OF ULCER. IMDRF PATIENT CODE E2314 CAPTURES THE REPORTABLE EVENT OF FISTULA.
ADDITIONAL INFORMATION BLOCK B5 AND H6 HAVE BEEN UPDATED, THE PATIENT CODE E2314 FISTULA WAS REMOVED DUE TO THE NEW INFORMATION. DETAILED PRODUCT INFORMATION WAS NOT PROVIDED TO BSC. WE COMPLETED A GOOD FAITH EFFORT TO OBTAIN THE INFORMATION. BECAUSE THE PRODUCT IS UNKNOWN AT THIS TIME, WE ARE UNABLE TO PROVIDE THE COMPLETED UDI AND OTHER PRODUCT SPECIFIC INFORMATION. IF ADDITIONAL DETAILS BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. BLOCKS D4 AND H4: THE COMPLAINANT WAS UNABLE TO REPORT THE LOT NUMBER; THEREFORE, THE MANUFACTURE DATE AND EXPIRATION DATE ARE UNKNOWN. BLOCK H6: IMDRF DEVICE CODE A150202 CAPTURES THE REPORTABLE EVENT OF GEL MISPLACEMENT NON-VASCULAR. IMDRF PATIENT CODE E0506 CAPTURES THE REPORTABLE EVENT OF BLEEDING. IMDRF PATIENT CODE E2330 CAPTURES THE REPORTABLE EVENT OF PAIN. IMDRF PATIENT CODE E232401 CAPTURES THE REPORTABLE EVENT OF FECAL INCONTINENCE. IMDRF PATIENT CODE E2311 CAPTURES THE REPORTABLE EVENT OF DISCOMFORT. IMDRF PATIENT CODE E2315 CAPTURES THE REPORTABLE EVENT OF FLUID DISCHARGE. IMDRF PATIENT CODE E2339 CAPTURES THE REPORTABLE EVENT OF ULCER.
IT WAS REPORTED THAT A PATIENT UNDERWENT A SPACEOAR VUE PLACEMENT PROCEDURE WITH FIDUCIAL MARKER SON (B)(6) 2025. A DIGITAL RECTAL EXAMINATION (DRE) WAS PERFORMED AT THE END OF THE PROCEDURE AND THERE WERE NO SIGNS OF PROBLEMS. A PLANNING COMPUTED TOMOGRAPHY (CT) WAS PERFORMED ON (B)(6) 2025. THERE WAS CONCERN OF A RECTAL WALL INFILTRATION OF THE HYDROGEL AND THE PATIENT WAS CONSTIPATED AT THE TIME. THE PATIENT UNDERWENT RADIATION TREATMENT AS PLANNED. ON (B)(6) 2025, THE PATIENT STARTED EXPERIENCING PAIN IN THE RECTUM, BLEEDING AND SOME FECAL INCONTINENCE. THE PATIENT REPORTED PASSING HYDROGEL THROUGH THEIR STOOLS, THEREFORE WAS ADMITTED TO THE MEDICAL WARD. THE PATIENT IS CURRENTLY STABLE WITH NO FURTHER SYMPTOMS OR ISSUES. A SIGMOIDOSCOPY LATER CONFIRMED A PERFORATION IN THE RECTUM, AND DURING THE PROCEDURE, THE SURGEON SUCCESSFULLY REMOVED THE ENTIRE HYDROGEL IN ONE PIECE. THE PATIENT WAS OFFERED A DIVERSION. THE PATIENT IS CLINICALLY WELL AND NOW IS WAITING FOR THE PLAN OF THE COLORECTAL SURGEON. THE PATIENT IS AVOIDING HARD STOOLS AND IS CURRENTLY ON AUGMENTIN. THE PATIENT IS CURRENTLY ASYMPTOMATIC.
IT WAS REPORTED THAT A PATIENT UNDERWENT A SPACEOAR VUE PLACEMENT PROCEDURE WITH FIDUCIAL MARKER SON (B)(6) 2025. A DIGITAL RECTAL EXAMINATION (DRE) WAS PERFORMED AT THE END OF THE PROCEDURE AND THERE WERE NO SIGNS OF PROBLEMS. A PLANNING COMPUTED TOMOGRAPHY (CT) WAS PERFORMED ON (B)(6) 2025. THERE WAS CONCERN OF A RECTAL WALL INFILTRATION OF THE HYDROGEL AND THE PATIENT WAS CONSTIPATED AT THE TIME. THE PATIENT UNDERWENT RADIATION TREATMENT AS PLANNED. ON (B)(6) 2025, THE PATIENT STARTED EXPERIENCING PAIN IN THE RECTUM, BLEEDING AND SOME FECAL INCONTINENCE. THE PATIENT REPORTED PASSING HYDROGEL THROUGH THEIR STOOLS, THEREFORE WAS ADMITTED TO THE MEDICAL WARD. THE PATIENT IS CURRENTLY STABLE WITH NO FURTHER SYMPTOMS OR ISSUES. A SIGMOIDOSCOPY LATER CONFIRMED A PERFORATION IN THE RECTUM, AND DURING THE PROCEDURE, THE SURGEON SUCCESSFULLY REMOVED THE ENTIRE HYDROGEL IN ONE PIECE. THE PATIENT WAS OFFERED A DIVERSION. THE PATIENT IS CLINICALLY WELL AND NOW IS WAITING FOR THE PLAN OF THE COLORECTAL SURGEON. THE PATIENT IS AVOIDING HARD STOOLS AND IS CURRENTLY ON AUGMENTIN. THE PATIENT IS CURRENTLY ASYMPTOMATIC. ADDITIONAL INFORMATION: IT WAS REPORTED THAT THE PATIENT ONLY HAS AN ULCER, THERE ARE NO SIGNS OF FISTULA.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2695651 | SPACEOAR VUE SYSTEM | ABSORBABLE PERIRECTAL SPACER | OVB | BOSTON SCIENTIFIC CORPORATION | SV-1010 | 00850009803009 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 75 YR | Male | Other| R |