BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

    MDR report key: 2100963 · Received May 24, 2011

    Report

    Report Number
    2024168-2011-03649
    Event Type
    Injury
    Date Received
    May 24, 2011
    Date of Event
    May 6, 2011
    Report Date
    May 6, 2011
    Manufacturer
    AV-TEMECULA-CT
    Product Code
    MGB
    PMA / PMN Number
    P960043
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, 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 FIRST PROGLIDE IS BEING FILED UNDER A SEPARATE MEDWATCH MFR NUMBER. A BLOCKED LUMEN, CAN OCCUR DUE TO A NUMBER OF FACTORS INCLUDING, BUT NOT LIMITED TO, LOW BLOOD PRESSURE, A BLOOD CLOT, TISSUE INTERFERENCE, THE MARKER PORT NOT BEING IN THE ARTERIAL LUMEN, THE MARKER PORT AGAINST THE PATIENT ARTERY OR A SMALL PATIENT VESSEL DIAMETER. THIS MAY HAVE BEEN A CONTRIBUTING FACTOR TO THIS EVENT, BUT COULD NOT BE CONFIRMED. THE RETURN OF THE DEVICE MAY HAVE AIDED THE INVESTIGATION IN DETERMINING A CAUSE FOR THE EXPERIENCED EVENT. TO ENSURE THIS TYPE OF EXPERIENCE IS NOT A RESULT OF A POTENTIAL PRODUCT RELATED DEFICIENCY, A SAMPLING OF FINISHED DEVICES IS ALSO TESTED TO VERIFY THE FUNCTIONALITY OF THE DEVICE. A REVIEW OF THE FINISHED PRODUCT LOT HISTORY RECORD DID NOT REVEAL ANY MANUFACTURING RELATED NON-CONFORMING MATERIAL RECORDS ASSOCIATED WITH THIS LOT. BASED ON THE INFORMATION RECEIVED WITH THIS INCIDENT AND WITHOUT THE PRODUCT TO EXAMINE, A DEFINITIVE CAUSE FOR THE REPORTED EXPERIENCE COULD NOT BE DETERMINED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A PHYSICIAN TRAINED IN THE USE OF THE PROGLIDE DEVICE ATTEMPTED TO PERFORM PRE-CLOSURE PLACEMENT OF THE SUTURES IN THE LEFT COMMON FEMORAL ARTERY PRIOR TO AN ABDOMINAL AORTIC ANEURYSM ENDOGRAFT PROCEDURE. REPORTEDLY, A CUFF MISS OCCURRED WITH THE FIRST DEVICE. BLOOD FLOW COULD NOT BE ACHIEVED THROUGH THE MARKER LUMEN OF THE SECOND DEVICE AND IT WAS REMOVED. A THIRD AND FOURTH DEVICE WERE SUCCESSFULLY PLACED AND THE PROCEDURE WAS CONTINUED AND WAS SUCCESSFULLY COMPLETED. THERE WERE NO REPORTED ADVERSE PATIENT SEQUELAE. 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 930226H

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Required Intervention HEPARIN