FDA Adverse Event Injury Summary report: N

ISLEEVE 14F

MDR report key: 10595803 · Received September 28, 2020

Report

Report Number
2134265-2020-13223
Event Type
Injury
Date Received
September 28, 2020
Date of Event
December 11, 2018
Report Date
September 28, 2020
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
DYB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PATIENT IDENTIFIER: (B)(6).

Description of Event or Problem · 1

IT WAS REPORTED THAT BLEEDING OCCURRED. THE PATIENT WAS ENROLLED IN THE (B)(6) STUDY WITH A PATIENT IDENTIFIER (B)(6). (B)(6) IS AN INVESTIGATOR-SPONSORED RESEARCH (ISR) CLINICAL STUDY INVOLVING THE ACCURATE NEO AORTIC BIOPROSTHESIS AND THE ACURATE TF TRANSFEMORAL DELIVERY SYSTEM. BOSTON SCIENTIFIC (BSC) RECEIVED DATA IN AN ANONYMIZED FORMAT. THEREFORE, FOR MAINTAINING PATIENT ANONYMITY, ONLY LIMITED INFORMATION WAS DISCLOSED TO BSC. BSC IS UNABLE TO ACQUIRE ANY FURTHER INFORMATION. PROCEDURE SUMMARY: THE PATIENT UNDERWENT THE TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) PROCEDURE. A 14F ISLEEVE INTRODUCER SHEATH WAS SELECTED FOR USE DURING THE PROCEDURE AND AN ACCURATE NEO VALVE WAS IMPLANTED. 1 DAYS POST PROCEDURE, BLEEDING OCCURRED AT THE VASCULAR ACCESS SITE ON THE RIGHT FEMORAL SIDE. THE BLEEDING WAS TREATED WITH STENTING AS THE CLOSURE SEAL AND OCCLUSION BALLOONING DID NOT REMEDY THE EVENT. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1059891 ISLEEVE 14F INTRODUCER, CATHETER DYB BOSTON SCIENTIFIC CORPORATION 10445

Patients

Seq Age Sex Outcome Treatment
1 86 YR Required Intervention