FDA Adverse Event Injury Summary report: N

PERCLOSE¿ PROSTYLE¿

MDR report key: 22177333 · Received June 10, 2025

Report

Report Number
2024168-2025-05968
Event Type
Injury
Date Received
June 10, 2025
Date of Event
May 19, 2025
Report Date
July 2, 2025
Manufacturer
ABBOTT VASCULAR INC.
Product Code
MGB
UDI-DI
08717648344039
PMA / PMN Number
P960043
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

ANALYSIS WAS PERFORMED ON THE RETURNED DEVICE. THE REPORTED NEEDLE TO CUFF MISS WAS NOT CONFIRMED AS NOT ALL COMPONENTS WERE RETURNED. PRODUCTION RECORD AND CORRECTIVE AND PREVENTIVE ACTIONS (CAPA) REVIEWS WERE PERFORMED AND REVEALED NO INDICATION OF A PRODUCT QUALITY ISSUE. THE REPORTED NEEDLE TO CUFF MISS 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. BASED ON THE INFORMATION REVIEWED, THERE IS NO INDICATION OF A PRODUCT QUALITY ISSUE WITH RESPECT TO THE DESIGN, MANUFACTURE, OR LABELING OF THE DEVICE. CORRECTIONS: D4 - MODEL #, CATALOG #: UPDATED FROM UNK PROSTYLE TO 12773-02. D4 - LOT #: UPDATED FROM UNKNOWN TO 4052241. D4 - PRIMARY UDI NUMBER: UPDATED FROM UNKNOWN TO (B)(4). D9 - DEVICE AVAILABLE FOR EVALUATION: UPDATED FROM NI TO YES.

Description of Event or Problem · 0

IT WAS REPORTED THAT THIS WAS AN ARTERIOTOMY CLOSURE OF A CALCIFIED RIGHT COMMON FEMORAL ARTERY USING TWO PROSTYLE DEVICES AFTER AN INTERVENTIONAL PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY PROCEDURE WITH A SMALL-BORE SHEATH. REPORTEDLY, AFTER REMOVING THE PLUNGER THERE WAS NO SUTURE VISIBLE FOR BOTH DEVICES. MANUAL COMPRESSION 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
1477751 PERCLOSE¿ PROSTYLE¿ DEVICE, HEMOSTASIS, VASCULAR MGB ABBOTT VASCULAR INC. 12773-02 4052241 08717648344039

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention