FDA Adverse Event Injury Summary report: N

PERCLOSE¿ PROSTYLE¿

MDR report key: 21308262 · Received February 4, 2025

Report

Report Number
2024168-2025-01303
Event Type
Injury
Date Received
February 4, 2025
Date of Event
November 1, 2024
Report Date
April 1, 2025
Manufacturer
ABBOTT VASCULAR INC.
Product Code
MGB
UDI-DI
08717648344039
PMA / PMN Number
P960043
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ANALYSIS WAS PERFORMED ON THE RETURNED DEVICE. THE REPORTED NEEDLE TO CUFF MISS WAS CONFIRMED. PRODUCTION RECORD AND CORRECTIVE AND PREVENTIVE ACTIONS (CAPA) REVIEWS WERE PERFORMED AND REVEALED NO INDICATION OF A PRODUCT QUALITY ISSUE. THE REPORTED DIFFICULTY AND SUBSEQUENT TREATMENT APPEAR TO BE RELATED TO AN INTERACTION OF THE DEVICE WITH PATIENT ANATOMY OR INABILITY TO MAINTAIN POSITION/STABILITY OF THE DEVICE DURING DEPLOYMENT DUE TO CIRCUMSTANCES OF THE PROCEDURE. THERE IS NO INDICATION OF A PRODUCT QUALITY ISSUE WITH RESPECT TO THE DESIGN, MANUFACTURE, OR LABELING OF THE DEVICE. CORRECTION: D4 - LOT #: UPDATED FROM 3071141 TO 3070241. D4 - PRIMARY UDI NUMBER: UPDATED FROM (B)(4). H4 - DEVICE MFG DATE: UPDATED FROM 7/11/2023 TO 7/2/2023. H6- MEDICAL DEVICE PROBLEM CODE: CODE 2616 WAS REMOVED AND CODE 1142 WAS ADDED.

Additional Manufacturer Narrative · 0

MANUFACTURER'S INVESTIGATION IS STILL PENDING AT THIS TIME. RESULTS AND CONCLUSIONS WILL BE PROVIDED IN THE FINAL REPORT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS WAS AN ARTERIOTOMY CLOSURE OF A RIGHT COMMON FEMORAL ARTERY USING A PROSTYLE RELATED TO AN UNKNOWN PROCEDURE. REPORTEDLY, AFTER REMOVING THE PLUNGER THE SUTURE CAME OUT OF THE NEEDLE AND THE KNOT WAS MADE OUTSIDE OF THE PATIENT. AN UNKNOWN METHOD WAS USED TO ACHIEVE HEMOSTASIS. THERE WAS NO ADVERSE PATIENT SEQUELA AND NO REPORTED CLINICALLY SIGNIFICANT DELAY IN THE PROCEDURE OR THERAPY. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
61281 PERCLOSE¿ PROSTYLE¿ DEVICE, HEMOSTASIS, VASCULAR MGB ABBOTT VASCULAR INC. 12773-02 3070241 08717648344039

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention