FDA Adverse Event Injury Summary report: N

PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

MDR report key: 2033044 · Received March 29, 2011

Report

Report Number
2024168-2011-02148
Event Type
Injury
Date Received
March 29, 2011
Date of Event
March 4, 2011
Report Date
March 4, 2011
Manufacturer
AV-TEMECULA-CT
Product Code
MGB
PMA / PMN Number
P960043
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DURING PROCESSING OF THIS COMPLAINT, ATTEMPTS WERE MADE TO OBTAIN COMPLETE EVENT, PATIENT AND DEVICE INFORMATION. THE CUSTOMER REPORTED THE DEVICE WAS DISCARDED. THE LOT NUMBER WAS NOT IDENTIFIED; THEREFORE, A DEVICE HISTORY RECORD REVIEW COULD NOT BE PERFORMED. THE OTHER PROGLIDE REFERENCED IS BEING REPORTED UNDER A SEPARATE MEDWATCH REPORT NUMBER.

Description of Event or Problem · 1

IT WAS REPORTED THAT A TECHNICIAN, TRAINED IN THE USE OF THE PROGLIDE DEVICE, ATTEMPTED ARTERIOTOMY CLOSURE OF THE COMMON FEMORAL ARTERY AFTER A DIAGNOSTIC PROCEDURE. REPORTEDLY, ALL DEPLOYMENT STEPS WERE COMPLETED UNEVENTFULLY, HOWEVER, BLEEDING WAS STILL OBSERVED COMING OUT OF THE PATIENT'S GROIN. THE DEVICE WAS REMOVED, THE TECHNICIAN ATTEMPTED VESSEL CLOSURE WITH ANOTHER PROGLIDE; HOWEVER, THE SAME ISSUE OCCURRED. THIS SECOND DEVICE WAS ALSO REMOVED FROM THE PATIENT'S ANATOMY AND MANUAL COMPRESSION WAS APPLIED TO ACHIEVE HEMOSTASIS. THE PATIENT DID NOT EXPERIENCE ANY ADVERSE EFFECT. THOUGH REQUESTED, NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM SUTURE MEDIATED CLOSURE MGB AV-TEMECULA-CT

Patients

Seq Age Sex Outcome Treatment
1 42 YR Required Intervention