FDA Adverse Event Malfunction Summary report: N

MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE MGB, PRODUCT CODE: MGB

MDR report key: 4276871 · Received November 18, 2014

Report

Report Number
3004939290-2014-00974
Event Type
Malfunction
Date Received
November 18, 2014
Date of Event
September 4, 2014
Report Date
September 4, 2014
Manufacturer
ACCESSCLOSURE, INC.
Product Code
MGB
PMA / PMN Number
P040044
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PROCESS EVALUATION.

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED; THEREFORE, A PHYSICAL INVESTIGATION COULD NOT BE PERFORMED. A REVIEW OF THE LHR (LOT F1402804) INDICATED THAT THE DEVICE THE LOT MET ALL ESTABLISHED PERFORMANCE CRITERIA PRIOR TO SHIPMENT. BASED ON THE INFORMATION PROVIDED AND NO RETURNED DEVICE FOR PHYSICAL INVESTIGATION, THE REPORTED EVENT COULD NOT BE CONFIRMED AND THE ROOT CAUSE COULD NOT BE DETERMINED.

Description of Event or Problem · 1

THE FOLLOWING INFORMATION WAS REPORTED: BALLOON LOSS OF PRESSURE BEFORE CONTACT WITH TIP OF SHEATH, MANUAL COMPRESSION WAS APPLIED FOR 20 MINUTES. THE PATIENT WAS NOT HOSPITALIZED. STICK LOCATION: COMMON FEMORAL ARTERY. VESSEL SIZE: 6MM. PROCEDURE: PERIPHERAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
745377 MYNXGRIP (6F/7F) VASCULAR CLOSURE DEVICE MGB, PRODUCT CODE: MGB MGB, PRODUCT CODE: MGB MGB ACCESSCLOSURE, INC. MX6721 F1402804

Patients

Seq Age Sex Outcome Treatment
1