FDA Adverse Event Injury Summary report: N

PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

MDR report key: 1842364 · Received September 18, 2010

Report

Report Number
2953144-2010-01976
Event Type
Injury
Date Received
September 18, 2010
Date of Event
November 14, 2008
Report Date
June 15, 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 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 TRAINED IN THE USE OF THE PERCLOSE PROGLIDE DEVICE ACHIEVED ARTERIOTOMY CLOSURE OF THE FEMORAL ARTERY AFTER AN INTERVENTIONAL PROCEDURE. REPORTEDLY, POST-PROCEDURE, THE RIGHT GROIN WAS "MOIST WITH DRAINAGE". THE GROIN SITE WAS TREATED WITH LIDOCAINE AND EPINEPHRINE INJECTION AT 09:00 HRS. REASSESSMENT OF THE GROIN DRESSING AT 09:15 HRS FOUND IT WAS DRY AND INTACT. THE PT WAS REPORTED TO BE PRESCRIBED ANTICOAGULANTS OF ASPIRIN AND CLOPIDOGREL, WHICH MAY HAVE INFLUENCED THE TISSUE TRACT OOZING. THERE WERE NO REPORTED ADVERSE PT EFFECTS. NO ADDITIONAL INFO WAS 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 64 YR Other