FDA Adverse Event Injury Summary report: N

SPACEOAR VUE? SYSTEM - 10ML

MDR report key: 25117969 · Received May 7, 2026

Report

Report Number
2124215-2026-24928
Event Type
Injury
Date Received
May 7, 2026
Date of Event
March 31, 2026
Report Date
May 7, 2026
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
OVB
UDI-DI
00864661000140
PMA / PMN Number
K182971
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

BLOCK H6: PATIENT CODE E060104 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF BRADYCARDIA. PATIENT CODE E2321 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF HYPOTENSION. PATIENT CODE E011903 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF SYNCOPE/FAINTING. PATIENT CODE E0119 IS BEING USED TO CAPTURE THE REPORTABLE EVENT OF LOSS OF CONSCIOUSNESS.

Description of Event or Problem · 0

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A SPACEOAR VUE WAS USED DURING A PLACEMENT PROCEDURE ON (B)(6) 2026, UNDER LOCAL ANESTHESIA. FOLLOWING THE PLACEMENT PROCEDURE, THE PATIENT STARTED FEELING LIGHT-HEADED AND EXPERIENCED BRADYCARDIA, HYPOTENSION, AND LOSS OF CONSCIOUSNESS. THE PATIENT RECEIVED CHEST COMPRESSIONS AND THE PATIENT CONTINUED TO BREATH ON HIS OWN, THE PATIENT'S PREVIOUSLY IMPLANTED DEFIBRILLATOR ACTIVATED. THE PATIENT WAS TRANSFERRED TO THE EMERGENCY DEPARTMENT WHILE RECEIVING LEVOPHED AND IV FLUID HYDRATION. THE PATIENT THEN WAS MONITORED AND ASSESSED FOR MYOCARDIAL INFARCTION, BUT IT WAS NEGATIVE AND LATER DISCHARGED. IN THE PHYSICIAN'S ASSESSMENT, THE EVENT WAS ATTRIBUTED TO A POSSIBLE VASOVAGAL RESPONSE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
530557 SPACEOAR VUE? SYSTEM - 10ML ABSORBABLE PERIRECTAL SPACER OVB BOSTON SCIENTIFIC CORPORATION SV-2101 0037522727 00864661000140

Patients

Seq Age Sex Outcome Treatment
1