FDA Adverse Event Injury Summary report: N

MANTA 18F

MDR report key: 22042511 · Received May 19, 2025

Report

Report Number
3010252479-2025-00051
Event Type
Injury
Date Received
May 19, 2025
Date of Event
April 30, 2025
Report Date
April 30, 2025
Manufacturer
ESSENTIAL MEDICAL, INC.
Product Code
MGB
UDI-DI
00856279007062
PMA / PMN Number
P180025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4)

Additional Manufacturer Narrative · 0

(B)(4). COMPLAINT VERIFICATION TESTING COULD NOT BE PERFORMED AS NO SAMPLE WAS RETURNED FOR ANALYSIS. THE DETAILS OF THE COMPLAINT WERE REVIEWED. IT IS LIKELY THAT THE DISSECTION OR VESSEL FACTORS CAUSED BY THE INITIAL STICK AND/OR THE E-SHEATH COULD HAVE LED TO OCCLUSION. A DEVICE HISTORY RECORD REVIEW WAS PERFORMED, AND NO RELEVANT FINDINGS WERE IDENTIFIED. WITHOUT THE DEVICE TO EVALUATE, THE COMPLAINT COULD NOT BE CONFIRMED, AND THE PROBABLE CAUSE COULD NOT BE DETERMINED FROM THE AVAILABLE INFORMATION. TELEFLEX WILL CONTINUE TO MONITOR AND TREND FOR REPORTS OF THIS NATURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT: "TAVR CASE. PHYSICIAN GOT ACCESS WITH MIK AND ULTRASOUND. PUFF OF CONTRAST SHOWED HE WAS IN A DISSECTION PLANE. REMOVED MIK, HELD PRESSURE AND RE-STUCK A SECOND TIME WITH MIK AND ULTRASOUND. PRE FEMORAL ANGIO WAS IN TRUE LUMEN, PROCEEDED WITH TAVR CASE. NO ISSUES ADVANCING SHEATHS. WHEN THE VALVE ENTERED THROUGH E-SHEATH, PATIENT BECAME IRRITABLE AND WAS IN PAIN. CONTINUED WITH THE TAVR PROCEDURE. PHYSICIAN WAS CONCERNED ABOUT THE DISSECTION FROM THE INITIAL STICK, SO HE TOOK AN ANGIO WITH THE SHEATH PULLED BACK TO THE FEMORAL. SHEATH WAS OCCLUSIVE. PHYSICIAN REMOVED E-SHEATH AND CLOSED WITH MANTA. WHEN PHYSICIAN TOOK THE ANGIO POST MANTA, THE VESSEL WAS OCCLUDED FROM ILIAC TO DISTAL TO THE MANTA CLOSURE. PHYSICIAN CONSULTED VASCULAR SURGERY. CUT DOWN WAS PERFORMED AND THE MANTA DEVICE WAS REMOVED IN ITS ENTIRETY. THE PATIENT WAS STABLE POST THE PROCEDURE."

Description of Event or Problem · 0

IT WAS REPORTED THAT: "TAVR CASE. PHYSICIAN GOT ACCESS WITH MIK AND ULTRASOUND. PUFF OF CONTRAST SHOWED HE WAS IN A DISSECTION PLANE. REMOVED MIK, HELD PRESSURE AND RE-STUCK A SECOND TIME WITH MIK AND ULTRASOUND. PRE FEMORAL ANGIO WAS IN TRUE LUMEN, PROCEEDED WITH TAVR CASE. NO ISSUES ADVANCING SHEATHS. WHEN THE VALVE ENTERED THROUGH E-SHEATH, PATIENT BECAME IRRITABLE AND WAS IN PAIN. CONTINUED WITH THE TAVR PROCEDURE. PHYSICIAN WAS CONCERNED ABOUT THE DISSECTION FROM THE INITIAL STICK, SO HE TOOK AN ANGIO WITH THE SHEATH PULLED BACK TO THE FEMORAL. SHEATH WAS OCCLUSIVE. PHYSICIAN REMOVED E-SHEATH AND CLOSED WITH MANTA. WHEN PHYSICIAN TOOK THE ANGIO POST MANTA, THE VESSEL WAS OCCLUDED FROM ILIAC TO DISTAL TO THE MANTA CLOSURE. PHYSICIAN CONSULTED VASCULAR SURGERY. CUT DOWN WAS PERFORMED AND THE MANTA DEVICE WAS REMOVED IN ITS ENTIRETY. THE PATIENT WAS STABLE POST THE PROCEDURE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
138542 MANTA 18F VASCULAR CLOSURE DEVICE MGB ESSENTIAL MEDICAL, INC. 73E2400582 00856279007062

Patients

Seq Age Sex Outcome Treatment
1 76 YR Unknown Required Intervention NOT REPORTED| NOT REPORTED