FDA Adverse Event Injury Summary report: N

MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE

MDR report key: 3945164 · Received July 18, 2014

Report

Report Number
3004939290-2014-00104
Event Type
Injury
Date Received
July 18, 2014
Report Date
July 7, 2014
Manufacturer
ACCESSCLOSURE, INC.
Product Code
MGB
PMA / PMN Number
P040044
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
NURSE

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

THE ACI REPRESENTATIVE REPORTED THAT A PATIENT UNDERWENT A PROCEDURE ON AN UNKNOWN DATE. FOLLOWING THE PROCEDURE, THE DEPLOYER SELECTED A MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE TO CLOSE THE ACCESS SITE. A HEMATOMA WAS NOTED WHICH WAS DESCRIBED TO BE "SIGNIFICANTLY" LARGER THAN 5 CM IN SIZE. THE PATIENT REQUIRED BETWEEN 10-15 MINUTES OF MANUAL COMPRESSION. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
422952 MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE MGB MGB ACCESSCLOSURE, INC. MX6721 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other