BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

    MDR report key: 1842365 · Received September 18, 2010

    Report

    Report Number
    2953144-2010-01972
    Event Type
    Injury
    Date Received
    September 18, 2010
    Date of Event
    August 11, 2008
    Report Date
    August 15, 2008
    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
    NC, 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. DEVICE# 1 PROGLIDE, PART# 12673-03, LOT# UNK, INDICATED IS BEING FILED UNDER A SEPARATE MANUFACTURER REPORT NUMBER. DEVICE # 3 PROGLIDE, PART# 12673-03, LOT# UNK, INDICATED IS BEING FILED UNDER A SEPARATE MEDWATCH MANUFACTURER REPORT NUMBER.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A PHYSICIAN TRAINED IN THE USE OF THE PERCLOSE PROGLIDE DEVICE ATTEMPTED ARTERIOTOMY CLOSURE OF THE COMMON FEMORAL ARTERY AFTER A DIAGNOSTIC PROCEDURE. REPORTEDLY, WHEN THE NEEDLE PLUNGER WAS RETRACTED, THE SUTURE WAS NOT PRESENT. THE DEVICE WAS REMOVED AND A SECOND AND THIRD PROGLIDE WAS USED WITH THE SAME RESULTS. ON THE FOURTH ATTEMPT WITH A PROGLIDE, HE REALIZED, HE FORGOT TO PERFORM STEP 2 (NEEDLE DEPLOYMENT TO CAPTURE THE SUTURE) ON THE PREVIOUS THREE DEVICES. THE FOURTH PROGLIDE ACHIEVED HEMOSTASIS. THERE WERE NO REPORTED ADVERSE PT EFFECTS. NO ADDITIONAL INFO WAS AVAILABLE.

    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 UNK Required Intervention PART# 12673-03, LOT# UNK| DEVICE #3 PROGLIDE| PART# 12673-03, LOT# UNK| DEVICE #1 PROGLIDE