SMALL BOWEL CAPSULE RECORDER SB3 DR3

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-26 for SMALL BOWEL CAPSULE RECORDER SB3 DR3 manufactured by Medtronic Inc. / Given Imaging Ltd..

Event Text Entries

[185491778] During small bowel capsule procedure, sb3 capsule did not take pictures.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5093951
MDR Report Key9888551
Date Received2020-03-26
Date of Report2020-03-25
Date of Event2020-01-15
Date Added to Maude2020-03-27
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSMALL BOWEL CAPSULE RECORDER SB3
Generic NameSYSTEM, IMAGING, ESOPHAGEAL, WIRELESS, CAPSULE
Product CodeNSI
Date Received2020-03-26
Model NumberDR3
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC INC. / GIVEN IMAGING LTD.


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-26

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