FDA Adverse Event Malfunction Summary report: N

PERCLOSE VASCULAR SUTURE DELIVERY DEVICE

MDR report key: 21987718 · Received May 8, 2025

Report

Report Number
MW5170125
Event Type
Malfunction
Date Received
May 8, 2025
Date of Event
April 4, 2025
Report Date
May 6, 2025
Manufacturer
ABBOTT VASCULAR
Product Code
MGB
Product Problem
Yes
Report Source
Voluntary report
Reporter Occupation
UNKNOWN
Health Professional
*

Narratives

Description of Event or Problem · 0

IT WAS REPORTED THAT AT THE END OF THE CASE WHILE THE PHYSICIAN WAS CLOSING UP USING A PERCLOSE VASCULATURE CLOSURE DEVICE, THE J WIRE BECAME STUCK IN THE VASCULATURE. THE CALLER REPORTED THAT THE PHYSICIAN WAS UNABLE TO RETRIEVE THE J WIRE. THE J WIRE WAS NOT A PART OF A BIOSENSE WEBSTER, INC. DEVICE. THE CALLER REPORTED THAT SHE WAS UNSURE IF THE J WIRE WAS A PART OF THE CLOSURE DEVICE. THE PHYSICIAN CONSULTED WITH VASCULAR. THE CALLER REPORTED THAT IT WAS UNKNOWN IF ANY FURTHER MEDICAL INTERVENTION WAS PROVIDED AT THE TIME OF THE CALL. THE LAST KNOWN PATIENT STATUS WAS STABLE. THE THERAPEUTIC/DIAGNOSTIC BWI PRODUCT IN USE WAS AN OCTARAY CATHETER. THE CARTO 3 SYSTEM WAS USED FOR MAPPING AND THE FARAPULSE SYSTEM WAS USED FOR ABLATION. THE PETAL XML WAS USED. THE NGEN SYSTEM WAS POWERED ON BUT NOT USED. ADDITIONAL INFORMATION PROVIDED. THE WIRE WAS SNARED FROM THE IJ BY INTERVENTIONAL CARDIOLOGY. NO FURTHER INJURIES OCCURRED AND THE PATIENT DID NOT HAVE ANY ADVERSE EVENTS FROM THIS. PATIENT IS FULLY RECOVERED. NO OTHER INFORMATION IS AVAILABLE. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
346497 PERCLOSE VASCULAR SUTURE DELIVERY DEVICE DEVICE, HEMOSTASIS, VASCULAR MGB ABBOTT VASCULAR

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown CARTO 3SYSTEM.| FARAPULSE SYSTEM.| OCTARAY CATHETER.| PETAL XML.