EI-530B OR EI-580BT N/A

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2018-06-22 for EI-530B OR EI-580BT N/A manufactured by Fujifilm Corporation.

Event Text Entries

[112031785] The opinion of the doctor who reported the information on the three cases is that: the ischemia could have been triggered by prolonged pressure of a balloon applied to the hepatic portal region (where the hepatic artery and portal systems are running). In addition, a trans-oral entry of the scope and prone position, and, in particular, increased pressure of the body under general anesthesia could increase the risk of developing ischemia. According to the information reported to date by the reporting doctor, the events could be related to the facts that patients were children, the procedures were performed under general anesthesia, the patients were in prone position, and the scopes were inserted through the mouth. Please refer to the attached report. These events are still under investigation at ((b)(6)). The investigation will assess these factors as potential causes. A supplemental report will be submitted when additional information is available and the investigation is concluded.
Patient Sequence No: 1, Text Type: N, H10


[112031786] This report is in regards to one (case 3) of three separate cases reported on may 25, 2018, to have occurred in (b)(6); where pediatric patients developed hepatic ischemia after a trans-oral dbe or dberc procedure. In all the cases the liver enzyme values (ast and alt) increased to more than 1000 after the procedure, the procedure was performed under general anesthesia and in a prone position. The affected endoscope model in this case is believed to be ei-530b or ei-580bt. These models are similar to the us cleared model en-580t, therefore, this case is being reported in an abundance of caution. This particular case reported in this mdr, (case 3) references site c and is very similar to case 2: a pediatric patient who had undergone living liver transplantation received a trans-oral dberc (double balloon enteroscope - retrograde cholangiopancreatography) in a prone position under general anesthesia and developed hepatic ischemia. The details and the date of this event is unknown.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3001722928-2018-00055
MDR Report Key7629650
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2018-06-22
Date of Report2018-12-10
Date Mfgr Received2018-11-12
Date Added to Maude2018-06-22
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Manufacturer ContactSAFETY OFFICER OFFICER
Manufacturer Street798 MIYANODAI KAISEI-MACHI KAISEI-MACHI
Manufacturer CityASHIGARAKAMI-GUN, KANAGAWA 258-8538
Manufacturer CountryJA
Manufacturer Postal258-8538
Manufacturer G1FUJIFILM CORPORATION
Manufacturer Street798 MIYANODAI KAISEI-MACHI KAISEI-MACHI
Manufacturer CityASHIGARAKAMI-GUN, KANAGAWA 258-8538
Manufacturer CountryJA
Manufacturer Postal Code258-8538
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameEI-530B OR EI-580BT
Generic NameENDOSCOPE
Product CodeFDA
Date Received2018-06-22
Model NumberEI-530B OR EI-580BT
Catalog NumberN/A
Lot NumberN/A
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerFUJIFILM CORPORATION
Manufacturer Address798 MIYANODAI KAISEI-MACHI KAISEI-MACHI ASHIGARAKAMI-GUN, KANAGAWA 258-8538 JA 258-8538


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-06-22

© 2024 FDA.report
This site is not affiliated with or endorsed by the FDA.