FDA Adverse Event Malfunction Summary report: N

NON LATEX MILLER AIR TIP

MDR report key: 4077251 · Received August 21, 2014

Report

Report Number
2411512-2014-00005
Event Type
Malfunction
Date Received
August 21, 2014
Date of Event
July 16, 2014
Report Date
July 17, 2014
Manufacturer
EZEM
Product Code
FGD
PMA / PMN Number
NA
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

COMPANY COMMENTS: A HEALTHCARE PROFESSIONAL REPORTED THAT IN 3 BARIUM ENEMA TESTS, THE BALLOON FAILED TO DEFLATE WHILE REMOVING THE CATHETER. GENERALLY, DURING THIS TYPE OF EXAMINATION, A LUBRICATED ENEMA TIP IS INSERTED INTO PATIENT'S RECTUM. THE TIP HAS A BALLOON THAT COULD BE INFLATED JUST ENOUGH TO KEEP BARIUM FROM LEAKING OUT (OF NOTE, NOT NECESSARILY THE BALLOON SHOULD BE COMPLETELY INFLATED). AS REPORTED IN LABELING, THE DEFLATION OF THE BALLOON SHOULD BE STARTED AFTER COMPLETION OF FLUOROSCOPY PHASE OF THE EXAM OR AFTER THE COLON IS COMPLETELY FILLED WITH BARIUM AND SHOULD BE COMPLETED BEFORE REMOVING THE ENEMA TIP. THIS APPROACH GUARANTEES GOOD IMAGINES DURING THE EXAMINATION AND AVOIDS LESIONS IN EXTRACTING A FULLY INFLATED BALLOON. BASED ON THE ABOVE AND CONSIDERING THAT NO CLINICAL CONSEQUENCES WERE REPORTED IN THE 3 PATIENTS, THE MANUFACTURER ARGUES THAT IN THESE CASES THE BALLOON WAS AT LEAST PARTIALLY DEFLATED BEFORE REMOVING IT. IN FACT, THE REMOVAL OF A FULLY INFLATED BALLOON WOULD HAVE BEEN QUITE IMPOSSIBLE AND WOULD HAVE LED TO A DIFFICULT EXTRACTION MANEUVERS WITH TRAUMATIC LESIONS OF THE RECTUM OR ANUS. IN ANY CASE, SINCE THE INFORMATION ON MANUFACTURER'S HANDS IS VERY SCANTY, IT WAS DECIDED TO HAVE A CONSERVATIVE APPROACH AND TO REPORT THESE CASES.

Description of Event or Problem · 1

NARRATIVE: CASE WAS RECEIVED FROM A HOSPITAL FLUOROSCOPY AND CARDIOLOGY LEAD RADIOGRAPHER AT (B)(6). ON (B)(6) 2014 AND FORWARDED TO (B)(6) (OPERATING ON BEHALF OF BRACCO) ON (B)(6) 2014. ON (B)(6) 2014, ADDITIONAL INFORMATION WAS RECEIVED FROM THE PRIMARY REPORTER DIRECTLY AT (B)(6). A HEALTH PROFESSIONAL REPORTS: ON (B)(6) 2014, THERE WERE 3 INCIDENTS OF BALLOON FAILING TO DEFLATE (NON LATEX MILLER AIR TIP, SYSTEM MODEL NO. 650012, LOT/SERIAL # (B)(4)) WHEN REMOVING THE CATHETER. CATHETERS WERE NOT KEPT BUT 1.5 BAGS LEFT OF THE SAME BATCH WHICH DEPT ARE NOW RELUCTANT TO USE. NO PATIENTS HAD ANY ADVERSE CONSEQUENCES AS A RESULT OF THE BALLOON NOT DEFLATING. THE RETURN OF ONE UNUSED SAMPLE OF THE SAME BATCH FOR INVESTIGATION HAS BEEN REQUESTED. OUTCOME: RECOVERED. FURTHER INFORMATION HAS BEEN REQUESTED. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
504952 NON LATEX MILLER AIR TIP CATHETER RETENTION BARIUM ENEMA WITH BAG FGD EZEM 650012 50724360

Patients

Seq Age Sex Outcome Treatment
1