FDA Adverse Event Other Summary report: N

BOOMERANG 610

MDR report key: 822554 · Received February 20, 2007

Report

Report Number
3004182619-2007-00004
Event Type
Other
Date Received
February 20, 2007
Date of Event
November 28, 2006
Report Date
February 20, 2007
Manufacturer
CARDIVA MEDICAL, INC.
Product Code
MGB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

PERIPHERAL INTERVENTION, 7 FR SHEATH, ANGIOMAX AND INTEGRILIN DRIP. HEMATOMA WAS EXPRESSED AND A FEMOSTOP WAS APPLIED FOR 4 HOURS. HEMATOMA SIZE - 4 INCHES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BOOMERANG 610 VASCULAR CLOSURE DEVICE MGB CARDIVA MEDICAL, INC. BOOMERANG 610 610061002A

Patients

Seq Age Sex Outcome Treatment
1 NO INFO Other