FDA Adverse Event Injury Summary report: N

PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM

MDR report key: 3841522 · Received May 30, 2014

Report

Report Number
2024168-2014-03488
Event Type
Injury
Date Received
May 30, 2014
Date of Event
January 15, 2014
Report Date
May 15, 2014
Manufacturer
AV-TEMECULA-CT
Product Code
MGB
PMA / PMN Number
P960043
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). ESTIMATED DATE OF OCCURRENCE, EXACT DATE WAS NOT REPORTED. CONCOMITANT PRODUCTS: GUIDE WIRE: 0.038 INCH; SHEATH: 5F; HEPARIN. (B)(4) - FAILURE TO FOLLOW STEPS/INSTRUCTIONS. PERFORM A FEMORAL ANGIOGRAM THROUGH THE INTRODUCER SHEATH TO VERIFY THAT THE ACCESS SITE IS IN THE COMMON FEMORAL ARTERY. TO AVOID POSTERIOR WALL SUTURE PLACEMENT AND POSSIBLE LIGATION OF THE ANTERIOR AND POSTERIOR WALLS OF THE FEMORAL ARTERY, FLUOROSCOPICALLY EVALUATE THE FEMORAL ARTERY FOR SIZE, CALCIUM, TORTUOSITY, AND FOR DISEASE OR DISSECTIONS OF THE ARTERIAL WALL. THE DEVICE IS EXPECTED TO BE RETURNED FOR INVESTIGATION. IT HAS NOT YET BEEN RECEIVED. A FOLLOW-UP REPORT WILL BE SUBMITTED WITH ALL ADDITIONAL RELEVANT INFORMATION.

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE DEVICE WAS RETURNED FOR ANALYSIS. THE J-TIP OF A RETURNED GUIDE WIRE WAS INSERTED THROUGH THE DISTAL END OF THE SHEATH AND EXITED AT THE EXIT RAMP OF THE SHEATH WITHOUT DIFFICULTY, THUS THE REPORTED DIFFICULTY TO INSERT THE DEVICE OVER THE GUIDE WIRE WAS NOT CONFIRMED. BASED ON A VISUAL AND FUNCTIONAL INSPECTION ANALYSIS OF THE RETURNED DEVICE, THERE IS NO INDICATION OF A PRODUCT DEFICIENCY. A REVIEW OF THE LOT HISTORY RECORD REVEALED NO NON-CONFORMANCES THAT WOULD HAVE CONTRIBUTED TO THE REPORTED EVENT. A QUERY OF THE ELECTRONIC COMPLAINT HANDLING DATABASE REVEALED NO OTHER INCIDENTS FOR DIFFICULTY TO INSERT THE DEVICE ONTO THE GUIDE WIRE REPORTED FROM THIS LOT. BASED ON THE INFORMATION REVIEWED, THERE IS NO INDICATION OF A PRODUCT DEFICIENCY. FIVE UNUSED, STERILE REPRESENTATIVE SAMPLES WITH THE LOT NUMBER 40107K1 WERE RETURNED FOR EVALUATION. FUNCTIONAL TESTING WAS PERFORMED AND THE DEVICES PASSED WITH ACCEPTABLE RESULTS. NO MALFUNCTION OR ABNORMAL OBSERVATIONS WERE DETECTED, BASED ON THE INVESTIGATION FINDINGS FROM THE TESTED SAMPLES.

Description of Event or Problem · 1

IT WAS REPORTED THAT AN ARTERIOTOMY CLOSURE OF THE COMMON FEMORAL ARTERY WAS ATTEMPTED USING THE PROGLIDE DEVICE WITH A 5F SHEATH AFTER AN PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (PTA) INTERVENTIONAL PROCEDURE. REPORTEDLY, THE PROGLIDE WOULD NOT ADVANCE OVER A STANDARD 0.038 INCH GUIDE WIRE. A SECOND PROGLIDE SUCCESSFULLY ADVANCED OVER THE GUIDE WIRE INTO THE ANATOMY. HEMOSTASIS WAS ACHIEVED WITH THE SECOND PROGLIDE DEVICE. THERE WERE NO REPORTED ADVERSE PATIENT SEQUELAE. NO CLINICALLY SIGNIFICANT DELAY IN THE PROCEDURE WAS REPORTED. NO FEMORAL ANGIOGRAM OR OTHER IMAGING WAS TAKEN. THE PHYSICIAN IS REPORTED TO BE TRAINED IN THE USE OF THE PROGLIDE DEVICE. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
318356 PERCLOSE PROGLIDE 6F SUTURE MEDIATED CLOSURE (SMC) SYSTEM SUTURE MEDIATED CLOSURE MGB AV-TEMECULA-CT 30730K1

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention