FDA Adverse Event Injury Summary report: N

PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

MDR report key: 1843490 · Received September 22, 2010

Report

Report Number
2953144-2010-02030
Event Type
Injury
Date Received
September 22, 2010
Date of Event
August 24, 2010
Report Date
August 31, 2010
Manufacturer
ABBOTT VASCULAR - VASCULAR SOLUTIONS
Product Code
MGB
PMA / PMN Number
P960043
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, 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 TRAINED IN THE USE OF THE PROGLIDE DEVICE ATTEMPTED ARTERIOTOMY CLOSURE OF THE MILDLY CALCIFIED RIGHT COMMON FEMORAL ARTERY AFTER AN UNSPECIFIED PROCEDURE. REPORTEDLY, WHEN THE NEEDLE PLUNGER WAS REMOVED, A CUFF MISS OCCURRED. THE PROGLIDE WAS REMOVED AND HEMOSTASIS WAS ACHIEVED USING A SECOND PROGLIDE DEVICE. THERE WERE NO REPORTED PATIENT ADVERSE EFFECTS. THOUGH REQUESTED, NO ADD'L 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 Required Intervention