FDA Adverse Event Injury Summary report: N

GORE HELEX SEPTAL OCCLUDER

MDR report key: 2851163 · Received November 27, 2012

Report

Report Number
2017233-2012-00788
Event Type
Injury
Date Received
November 27, 2012
Date of Event
August 1, 2012
Report Date
October 29, 2012
Manufacturer
W.L. GORE & ASSOCIATES
Product Code
MLV
PMA / PMN Number
P050006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS REPORTABLE EVENT CAME FROM THE ARTICLE: HEINISCH C, ET.AL. PERCUTANEOUS CLOSURE OF THE PATENT FORAMEN OVALE USING THE HELEX SEPTAL OCCLUDER: ACUTE AND LONG-TERM RESULTS IN 405 PTS. EUROINTERVENTION 2012;8:717-723. SEVERAL ATTEMPTS WERE MADE TO GATHER THE REQUIRED MISSING INFO.

Description of Event or Problem · 1

IN THE LITERATURE ARTICLE, "PERCUTANEOUS CLOSURE OF THE PATENT FORAMEN OVALE USING THE HELEX SEPTAL OCCLUDER: ACUTE AND LONG-TERM RESULTS IN 405 PTS", IT WAS REPORTED THE PHYSICIAN IMPLANTED A GORE HELEX SEPTAL OCCLUDER TO CLOSE A PATENT FORAMEN OVALE. "A THROMBUS WAS DISCOVERED ON THE RIGHT DISC OF THE OCCLUDER DURING A ROUTINE SIX-MONTH F/U. THE PT HAD BEEN TAKING ASPIRIN AT THE TIME OF THE EVENT, WHICH WAS CONTINUED THREE FURTHER MONTHS AT WHICH TIME A F/U VISIT REVEALED THROMBUS RESOLUTION."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GORE HELEX SEPTAL OCCLUDER MLV / OCCLUDER, TRANSCATHETER SEPTAL MLV W.L. GORE & ASSOCIATES

Patients

Seq Age Sex Outcome Treatment
1 Other