FDA Adverse Event Other Summary report: N

STARCLOSE VASCULAR CLOSURE SYSTEM

MDR report key: 811365 · Received January 24, 2007

Report

Report Number
2953144-2007-00047
Event Type
Other
Date Received
January 24, 2007
Date of Event
November 4, 2006
Report Date
January 4, 2007
Manufacturer
ABBOTT VASCULAR, INC.
Product Code
FZP
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS NOT RETURNED AND THERE WAS NO LOT INFO. WE WERE NOT ABLE TO PERFORM DEVICE INSPECTION OR DEVICE HISTORY RECORD REVIEW IN THIS CASE.

Description of Event or Problem · 1

THE PHYSICIAN SUCCESSFULLY CLOSED AN ARTERIOTOMY SITE WITH THE STARCLOSE DEVICE FOLLOWING AN UNK PROCEDURE IN 2006. THE PT RETURNED TO THE HOSP IN 2007, COMPLAINING OF PAIN IN THE GROIN. AN ANGIO REVEALED AN OCCLUSION AT THE PREVIOUS ACCESS SITE (COMMON FEMORAL ABOVE BIFURCATION). UNDER FLUORO, THE CLIP COULD BE SEEN AND THERE WAS NO OR SLOW CONTRAST FLOW AFTER THE CLIP SITE. A SURGICAL PROCEDURE IS PLANNED TO EITHER OPEN UP THE ARTERY OR REMOVE THE CLIP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STARCLOSE VASCULAR CLOSURE SYSTEM VASCULAR CLOSURE SYSTEM FZP ABBOTT VASCULAR, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 YR Other