FDA Adverse Event Injury Summary report: N

LIGACLIP*EXTRA TITANIUM CLIPS

MDR report key: 7869127 · Received September 12, 2018

Report

Report Number
3005075853-2018-12645
Event Type
Injury
Date Received
September 12, 2018
Report Date
August 17, 2018
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
FZP
UDI-DI
20705036012839
PMA / PMN Number
K830503
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE LOT/BATCH WAS NOT PROVIDED; THEREFORE, THE MANUFACTURING RECORDS COULD NOT BE REVIEWED.

Description of Event or Problem · 1

IT WAS REPORTED VIA JOURNAL ARTICLE: TITLE: MID-TERM OUTCOMES OF PATIENTS UNDERGOING ADJUSTABLE PULMONARY ARTERY BANDING AUTHORS: SACHIN TALWAR, NEERAJ ARAVIND KAMAT, SHIV KUMAR CHOUDHARY, SIVASUBRAMANIAN RAMAKRISHNAN, ANITA SAXENA, RAJNISH JUNEJA, SHYAM SUNDER KOTHARI, AND BALRAM AIRAN CITATION: I N D I A N H E A R T J O U R N A L 6 8 ( 2 0 1 6 ) 7 2 ¿ 7 6, HTTP://DX.DOI.ORG/10.1016/J.IHJ.2015.06.036. THE AIM OF THIS STUDY WAS TO ANALYZE THE OUTCOMES OF APAB IN THE MID-TERM IN TERMS OF THE REDUCTION OF PA PRESSURES AND SUITABILITY FOR DEFINITIVE PALLIATION AND TO STUDY THE BAND RELATED COMPLICATIONS ENCOUNTERED AT DEFINITIVE SURGERY. BETWEEN JANUARY 2002 UNTIL DECEMBER 2002, 73 PATIENTS UNDERWENT ADJUSTABLE PULMONARY ARTERY BAND (APAB) WERE INCLUDED IN THE STUDY. DURING THE PROCEDURE, THE MPA WAS LOOPED WITH A NO. 2 ETHIBOND (JOHNSON AND JOHNSON INC, SOMERVILLE, NJ) SUTURE AFTER PASSING A RIGHT-ANGLE FORCEPS BETWEEN THE AORTA AND THE MPA. BOTH ARMS OF THE SUTURE WERE CLIPPED TOGETHER WITH A LIGACLIP (LT 200; ETHICON ENDOSURGERY INC, CINCINNATI, OH) JUST ON THE PLEDGET. THESE SUTURES WERE BROUGHT OUT THROUGH THE PERICARDIUM AND THE LATERAL EDGE OF THE STERNUM AND THEN THROUGH SUBCUTANEOUS TISSUE AND SKIN. AFTER STERNAL CLOSURE, THE TWO ENDS OF THE SUTURE WERE PASSED THROUGH ANOTHER 1¿2 CM PTFE PLEDGET, AND THESE WERE CLIPPED TOGETHER WITH A BIG LIGACLIP (LT 400, ETHICON ENDOSURGERY). THE ENDS OF THE SUTURE WERE THEN TIED TO FORM A LOOP. SUBSEQUENT BAND TIGHTENING WAS ACHIEVED BY PLACING ADDITIONAL BIG LIGACLIPS BETWEEN THE EXTERNAL PTFE PLEDGET AND THE PREVIOUSLY PLACED LIGACLIP. ONCE SATISFACTORY GRADIENTS WERE ACHIEVED; THE BAND WAS INTERNALIZED BY SIMPLY OPENING ONE OF THE SKIN SUTURES, CLIPPING THE TWO ENDS OF THE ETHIBOND SUTURE AGAINST THE STERNUM USING A SMALL LIGACLIP, AND CUTTING THE ETHIBOND SUTURE ABOVE IT. THERE WAS 1 PATIENT HAD PSEUDOANEURYSM OF THE MAIN PULMONARY ARTERY (MPA) WITH STERNAL SINUS INFECTION AND REQUIRED SURGICAL RECONSTRUCTION. 1 PATIENT HAD INFECTIVE ENDOCARDITIS OF THE PULMONARY VALVE MANAGED MEDICALLY. IN CONCLUSION, PATIENTS UNDERGOING APAB ACHIEVED ADEQUATE PALLIATION OVER THE MID-TERM AND EITHER PROCEEDED TO OR WERE AWAITING DEFINITIVE REPAIR. SIGNIFICANT BAND-RELATED COMPLICATIONS WERE NOT ENCOUNTERED. THE TECHNIQUE OF APAB DESCRIBED BY US IS THUS ADVANTAGEOUS NOT ONLY IN THE SHORT-TERM AS DEMONSTRATED BY US PREVIOUSLY, BUT IS ALSO ASSOCIATED WITH ACCEPTABLE MIDTERM RESULTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
709514 LIGACLIP*EXTRA TITANIUM CLIPS CLIP, IMPLANTABLE FZP ETHICON ENDO-SURGERY, LLC. UNK 20705036012839

Patients

Seq Age Sex Outcome Treatment
1