BEUDAMED
    FDA Adverse Event Other Summary report: N

    PERCLOSE/ABBOTT

    MDR report key: 442051 · Received January 29, 2003

    Report

    Report Number
    MW1027474
    Event Type
    Other
    Date Received
    January 29, 2003
    Date of Event
    January 16, 2003
    Report Date
    January 16, 2003
    Manufacturer
    ABBOTT VASCULAR
    Product Code
    MGB
    Report Source
    Voluntary report
    Reporter Location
    SC, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    HEMOSTASIS NOT ACHIEVED. SYVEK PATCH USED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PERCLOSE/ABBOTT PERCLOSE - AT MGB ABBOTT VASCULAR M136123307 95109-6H

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Other