FDA Adverse Event Injury Summary report: N

6F ANGIO-SEAL VIP VASCULAR CLOSURE DEVICE, OUS

MDR report key: 17892733 · Received October 8, 2023

Report

Report Number
3013394970-2023-00542
Event Type
Injury
Date Received
October 8, 2023
Date of Event
April 19, 2022
Report Date
October 8, 2023
Manufacturer
TERUMO MEDICAL CORPORATION
Product Code
MGB
PMA / PMN Number
P930038
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE PRODUCTION LOT NUMBER WAS NOT PROVIDED BY THE USER FACILITY, WHICH PREVENTED A MEANINGFUL REVIEW OF THE DEVICE HISTORY RECORD. THE ACTUAL DEVICE WAS NOT RETURNED; THEREFORE, AN EVALUATION OF THE ACTUAL DEVICE WAS UNABLE TO BE CONDUCTED. THE COMPLAINT WAS CONFIRMED FOR A POTENTIAL CLOSURE COMPLICATION RESULTING IN A HEMATOMA AND REVISION SURGERY. THE EXACT ROOT CAUSE WAS UNABLE TO BE DETERMINED. THE LIKELY CAUSE WAS DETERMINED TO HAVE BEEN PROCEDURAL TECHNIQUE OR PROCEDURAL FACTORS CONTRIBUTING TO THE REPORTED ADVERSE EVENT. THE DEVICE HISTORY RECORD (DHR) WAS UNABLE TO BE REVIEWED AS A VALID LOT NUMBER WAS NOT IDENTIFIED. THERE IS NO INDICATION THAT ANY MANUFACTURING, DESIGN, OR QUALITY SYSTEM ISSUES MAY HAVE LED TO THIS EVENT. CURRENTLY, NO ACTION IS RECOMMENDED SINCE THIS RISK EVALUATION IS WITHIN THE PREDETERMINED LIMITS IN THE FAILURE MODE AND EFFECTS ANALYSIS (FMEA). THIS REPORT IS FOR THE FIRST DEVICE/PATIENT REPORTED, FOR THE SECOND DEVICE/PATIENT REPORTED THAT HAD DEVELOPED A HEMATOMA SEE MDR 3013394970-2023-00543.

Description of Event or Problem · 0

FROM LITERATURE REVIEW: ZENUNAJ, G, TRAINA, L, ACCIARRI, P, MUCIGNAT, M, SCIAN, S, ALESIANI, F, SERRA, R, GASBARRO, V. SUPERFICIAL FEMORAL ARTERY ACCESS FOR INFRAINGUINAL ANTEGRADE ENDOVASCULAR INTERVENTIONS IN THE HOSTILE GROIN: A PROSPECTIVE RANDOMIZED STUDY. ANNALS OF VASCULAR SURGERY. 2022. 86: PAGES. A PROSPECTIVE OBSERVATIONAL RANDOMIZED STUDY EXAMINED PATIENTS WITH SYMPTOMATIC PERIPHERAL ARTERIAL DISEASE WHO REQUIRED ENDOVASCULAR INTERVENTIONS AT THE LOWER EXTREMITIES. THE STUDY COMPARED A CUTDOWN APPROACH TO THE PERCUTANEOUS PUNCTURE TECHNIQUE. A 6FR ANGIO-SEAL VIP WAS USED TO ACHIEVE HEMOSTASIS IN THE PERCUTANEOUS PUNCTURE TECHNIQUE. TWO OF THE PATIENTS HAD PROCEDURAL HEMATOMAS. THIS COMPLAINT IS BEING OPENED FOR THE HEMATOMA THAT REQUIRED SURGICAL REVISION. SURGICAL REVISION WAS DONE WITH PRIMARY SUTURE REPAIR OF THE ARTERIOTOMY AND BLOOD TRANSFUSION WITH 1 UNIT OF RED PACKED BLOOD CELLS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2156947 6F ANGIO-SEAL VIP VASCULAR CLOSURE DEVICE, OUS DEVICE, HEMOSTASIS, VASCULAR MGB TERUMO MEDICAL CORPORATION N/A

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention| O