FDA Adverse Event Injury Summary report: N

PERCLOSE¿ PROSTYLE¿

MDR report key: 22907510 · Received August 27, 2025

Report

Report Number
2024168-2025-09156
Event Type
Injury
Date Received
August 27, 2025
Date of Event
August 6, 2025
Report Date
November 13, 2025
Manufacturer
ABBOTT VASCULAR INC.
Product Code
MGB
UDI-DI
08717648344039
PMA / PMN Number
P960043
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

D4: CORRECTED LOT NUMBER UPDATED FROM 4061841 TO 5030741 D4: CORRECTED EXPIRATION DATE FROM 5/31/2026 TO 2/28/2027 D4: CORRECTED PRIMARY UDI NUMBER FROM (B)(4). H4: CORRECTED DEVICE MFG DATE FROM 6/18/2024 TO 3/7/2025.

Additional Manufacturer Narrative · 0

ANALYSIS WAS PERFORMED ON THE RETURNED DEVICE. THE REPORTED SUTURE RETRIEVAL ISSUE WAS OBSERVED AS A LINK SEPARATION. PRODUCTION RECORD AND CORRECTIVE AND PREVENTIVE ACTIONS (CAPA) REVIEWS WERE PERFORMED AND REVEALED NO INDICATION OF A PRODUCT QUALITY ISSUE. THE REPORTED DIFFICULTIES AND SUBSEQUENT TREATMENT APPEAR TO BE RELATED TO AN INTERACTION OF THE DEVICE WITH PATIENT ANATOMY, LINK PULLED UNTIL IT BREAKS DUE TO CIRCUMSTANCES OF THE PROCEDURE. THERE IS NO INDICATION OF A PRODUCT QUALITY ISSUE WITH RESPECT TO DESIGN, MANUFACTURE OR LABELING OF THE DEVICE. D9: DEVICE AVAILABLE FOR EVALUATION FROM NO TO YES. H6: COMPONENT CODE 4755 WAS REMOVED. H6: TYPE OF INVESTIGATION CODE 4114 WAS REMOVED. H11: ADDITIONAL MFG NARRATIVE: REVISED.

Additional Manufacturer Narrative · 0

THE DEVICE WAS NOT RETURNED FOR ANALYSIS. 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. 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. THE ADDITIONAL DEVICE REFERENCED IN B5 IS BEING FILED UNDER A SEPARATE MEDWATCH REPORT.

Description of Event or Problem · 0

IT WAS REPORTED THIS WAS AN ARTERIOTOMY CLOSURE OF A COMMON FEMORAL ARTERY USING A PROSTYLE DEVICE. REPORTEDLY, TWO PROSTYLE DEVICES DID NOT SUCCESSFULLY PUNCTURE THE VESSEL. A NEW PROSTYLE DEVICE WAS USED TO ACHIEVE HEMOSTASIS. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1312881 PERCLOSE¿ PROSTYLE¿ DEVICE, HEMOSTASIS, VASCULAR MGB ABBOTT VASCULAR INC. 12773-02 5030741 08717648344039

Patients

Seq Age Sex Outcome Treatment
1 72 YR Male Required Intervention