FDA Adverse Event Injury Summary report: N

PERCLOSE¿ PROSTYLE¿

MDR report key: 21460849 · Received February 25, 2025

Report

Report Number
2024168-2025-02053
Event Type
Injury
Date Received
February 25, 2025
Date of Event
February 3, 2025
Report Date
April 22, 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
UK
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ANALYSIS WAS PERFORMED ON THE RETURNED DEVICE. THE RETURNED PRODUCT OBSERVATION DETERMINED A NEEDLE TO CUFF MISS. PRODUCTION RECORD AND CORRECTIVE AND PREVENTIVE ACTIONS (CAPA) REVIEWS WERE PERFORMED AND REVEALED NO INDICATION OF A PRODUCT QUALITY ISSUE. BASED ON THE OBSERVATIONS FROM THE RETURNED ANALYSIS, THE INVESTIGATION DETERMINED THAT THE OBSERVED NEEDLE TO CUFF MISS AND SUBSEQUENT TREATMENT APPEAR TO BE RELATED TO OPERATIONAL CONTEXT. IT IS LIKELY THAT 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. BASED ON THE RESULTS OF THE COMPLAINT INVESTIGATION, THERE IS NO INDICATION OF A PRODUCT QUALITY ISSUE WITH RESPECT TO DESIGN, MANUFACTURE OR LABELING OF THE DEVICE. D4 CORRECTION: MODEL, CATALOG NUMBER UPDATED FROM UNK PROSTYLE TO 12773-02. D4 CORRECTION: LOT NUMBER UPDATED FROM UNKNOWN TO 4032641.

Additional Manufacturer Narrative · 0

MANUFACTURER'S INVESTIGATION IS STILL PENDING AT THIS TIME. RESULTS AND CONCLUSIONS WILL BE PROVIDED IN THE FINAL REPORT. B3: DATE ESTIMATED. D4: THE UDI IS NOT KNOWN AS THE PART AND LOT NUMBER WERE NOT PROVIDED. THE ADDITIONAL DEVICE REFERENCED IN B5 IS FILED UNDER A SEPARATE MEDWATCH REPORT NUMBER.

Description of Event or Problem · 0

SUBSEQUENT TO THE INITIALLY FILED REPORT, THE FOLLOWING INFORMATION WAS RECEIVED: IT WAS REPORTED THAT THIS WAS A CLOSURE USING TWO PROSTYLE DEVICES. NO ADDITIONAL INFORMATION WAS PROVIDED.

Description of Event or Problem · 0

THE DATE OF EVENT IS ESTIMATED AS 2/3/2025 AS THIS IS THE DAY BEFORE THE ALERT DATE. IT WAS REPORTED THAT THIS WAS A CLOSURE USING TWO PROGLIDE DEVICES. REPORTEDLY, AN UNSPECIFIED FAILURE OCCURRED. THE METHOD USED TO ACHIEVE HEMOSTASIS WAS NOT PROVIDED. 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
424587 PERCLOSE¿ PROSTYLE¿ DEVICE, HEMOSTASIS, VASCULAR MGB ABBOTT VASCULAR INC. 12773-02 4032641 08717648344039

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention