FDA Adverse Event Injury Summary report: N

PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

MDR report key: 1842249 · Received September 18, 2010

Report

Report Number
2953144-2010-01984
Event Type
Injury
Date Received
September 18, 2010
Date of Event
October 31, 2008
Report Date
May 12, 2009
Manufacturer
ABBOTT VASCULAR-VASCULAR SOLUTIONS
Product Code
MGB
PMA / PMN Number
P960043
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE CUSTOMER REPORTED THE DEVICE WAS DISCARDED. THE LOT NUMBER WAS NOT IDENTIFIED; THEREFORE, A DEVICE HISTORY RECORD REVIEW COULD NOT BE PERFORMED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PHYSICIAN ACHIEVED ARTERIOTOMY CLOSURE OF THE FEMORAL ARTERY USING A PROGLIDE DEVICE AFTER AN INTERVENTIONAL PROCEDURE. REPORTEDLY AFTER THE PROCEDURE, THERE WAS RIGHT GROIN SITE OOZING - SEROSANGUINOUS DRAINAGE AND MILD ECCHYMOSIS AT THE ACCESS SITE. NO TREATMENT WAS REPORTED. HEMOSTASIS WAS ACHIEVED WITH THE DEVICE. THERE WERE NO PATIENT EFFECTS REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM MGB ABBOTT VASCULAR-VASCULAR SOLUTIONS NA UNK

Patients

Seq Age Sex Outcome Treatment
1 49 YR Other