FDA Adverse Event Injury Summary report: N

STARCLOSE SE VASCULAR CLOSURE SYSTEM

MDR report key: 1842110 · Received September 20, 2010

Report

Report Number
2953144-2010-02012
Event Type
Injury
Date Received
September 20, 2010
Date of Event
August 23, 2010
Report Date
August 26, 2010
Manufacturer
ABBOTT VASCULAR - VASCULAR SOLUTIONS
Product Code
MGB
PMA / PMN Number
P050007
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE IS EXPECTED TO BE RETURNED FOR EVALUATION. IT HAS NOT YET BEEN RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PHYSICIAN TRAINED IN THE USE OF STARCLOSE SE DEVICE ATTEMPTED ARTERIOTOMY CLOSURE OF THE COMMON FEMORAL ARTERY AFTER AN INTERVENTIONAL PROCEDURE. REPORTEDLY, THERE WAS DIFFICULTY SPLITTING THE SHEATH DURING ADVANCING THE THUMB ADVANCER. THE DEVICE WAS REMOVED AND HEMOSTASIS WAS ACHIEVED USING MANUAL COMPRESSION. THERE WERE NO REPORTED ADVERSE PATIENT EFFECTS. THOUGH REQUESTED, NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STARCLOSE SE VASCULAR CLOSURE SYSTEM MGB ABBOTT VASCULAR - VASCULAR SOLUTIONS NA 86038-6H

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention