FDA Adverse Event Injury Summary report: N

6F ANGIO-SEAL VASCULAR CLOSURE DEVICE STS PLUS

MDR report key: 1242981 · Received November 20, 2008

Report

Report Number
2182269-2008-00327
Event Type
Injury
Date Received
November 20, 2008
Date of Event
January 1, 2006
Report Date
November 20, 2008
Manufacturer
ST. JUDE MEDICAL
Product Code
MGB
PMA / PMN Number
P930038
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT WAS RETURNED FOR EVALUATION AND REVIEW OF THE DEVICE HISTORY RECORD WAS NOT POSSIBLE SINCE THE LOT NUMBER WAS UNAVAILABLE. BASED ON THE INFORMATION PROVIDED TO ST. JUDE MEDICAL, THE CAUSE FOR THE REPORTED EVENT COULD NOT BE CONCLUSIVELY DETERMINED. THE ANGIO-SEAL INSTRUCTION FOR USE (IFU) STATES SHOULD ISCHEMIC SYMPTOMS APPEAR, TREATMENT OPTIONS INCLUDE THROMBOLYSIS, PERCUTANEOUS EXTRACTION OF THE ANCHOR OR FRAGMENTS, OR SURGICAL INTERVENTION.

Description of Event or Problem · 1

IT WAS REPORTED IN A PRINTED LITERATURE ARTICLE THAT THE PATIENT WAS OPERATED ON ELECTIVELY FOLLOWING A VASCULAR COMPLICATION. THE PATIENT HAD DILATION OF THE SUPERFICIAL FEMORAL ARTERY. DIAGNOSIS OF ARTERIAL OCCLUSION WAS MADE BY DUPLEX SCAN. THE PATIENT SHOWED OCCLUSION OR HIGH GRADE STENOSIS OF THE COMMON FEMORAL ARTERY. INTRAOPERATIVE FINDINGS CONSISTED OF A COMPLETE ARTERIAL OCCLUSION WITH THE WHOLE ANGIO-SEAL DEVICE LOCATED INTRALUMINALLY IN THE FEMORAL ARTERY IN THE PATIENT CAUSING DISSECTION OF THE COMMON FEMORAL ARTERY. THE PATIENT UNDERWENT SUCCESSFUL SURGICAL INTERVENTION. A FASCIOTOMY WAS PERFORMED WHICH THEN WAS SECONDARILY CLOSED FOUR DAYS LATER. 1-12 MONTHS LATER, FOLLOW UP WAS COMPLETED AND NO INTERVENTION WAS REQUIRED. THE IMPLANT, EXPLANT, AND EVENT DATES ARE BETWEEN EARLY AND LATE 2006. LITERATURE ARTICLE FROM VASCULAR AND ENDOVASCULAR SURGERY (2008) 42, 225-227.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 6F ANGIO-SEAL VASCULAR CLOSURE DEVICE STS PLUS ANGIO-SEAL DEVICE MGB ST. JUDE MEDICAL NA UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention