FDA Adverse Event Injury Summary report: N

STARCLOSE SE VASCULAR CLOSURE SYSTEM

MDR report key: 1842134 · Received September 20, 2010

Report

Report Number
2953144-2010-02010
Event Type
Injury
Date Received
September 20, 2010
Date of Event
August 26, 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
NL
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT YET COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PHYSICIAN TRAINED IN THE USE OF THE STARCLOSE SE DEVICE ATTEMPTED ARTERIOTOMY CLOSURE OF AN UNSPECIFIED VESSEL AFTER AN INTERVENTIONAL PROCEDURE. REPORTEDLY, THE SHEATH WAS DIFFICULT TO SPLIT RESULTING IN THE CLIP FAILING TO DEPLOY. THE METHOD USED TO ACHIEVE HEMOSTASIS WAS NOT REPORTED. THERE WERE NO REPORTED ADVERSE EFFECTS. 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 90038-6H

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention