BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ABBOTT VASCULAR PERCLOSE

    MDR report key: 6710518 · Received July 11, 2017

    Report

    Report Number
    MW5070954
    Event Type
    Malfunction
    Date Received
    July 11, 2017
    Date of Event
    June 6, 2017
    Report Date
    June 27, 2017
    Manufacturer
    ABBOTT
    Product Code
    MGB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PERCLOSE FOOT BROKE OFF IN THE PT REQUIRING SURGICAL INTERVENTION TO RETRIEVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    485138 ABBOTT VASCULAR PERCLOSE PERCLOSE DEVICE MGB ABBOTT 12673-03 7012741

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR