FDA Adverse Event Injury Summary report: N

MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE

MDR report key: 3930944 · Received July 13, 2014

Report

Report Number
3004939290-2014-00091
Event Type
Injury
Date Received
July 13, 2014
Report Date
June 26, 2014
Manufacturer
ACCESSCLOSURE, INC.
Product Code
MGB
PMA / PMN Number
P040044
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED; THEREFORE, A PHYSICAL INVESTIGATION COULD NOT BE PERFORMED. BASED ON THE INFORMATION PROVIDED, THE ROOT CAUSE OF THE REPORTED EVENT COULD NOT BE DETERMINED. A REVIEW OF THE LHR WAS NOT POSSIBLE AS THE LOT NUMBER WAS NOT PROVIDED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT AN INTERVENTIONAL CORONARY PROCEDURE ON AN UNKNOWN DATE. FOLLOWING THE PROCEDURE, THE PHYSICIAN SELECTED A MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE TO CLOSE THE ACCESS SITE. IT WAS REPORTED THAT THE DEPLOYMENT WAS FINE BUT THE PATIENT DEVELOPED A HEMATOMA (SIZE UNKNOWN). MANUAL COMPRESSION WAS APPLIED FOR MORE THAN 30 MINUTES. THE PATIENT WAS NOT HOSPITALIZED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
409029 MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE MGB MGB ACCESSCLOSURE, INC. MX6721 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other| R