FDA Adverse Event Other Summary report: N

STARCLOSE VASCULAR CLOSURE SYSTEM

MDR report key: 959810 · Received April 25, 2007

Report

Report Number
2953144-2007-00536
Event Type
Other
Date Received
April 25, 2007
Date of Event
June 26, 2005
Report Date
June 27, 2005
Manufacturer
ABBOTT VASCULAR INC.
Product Code
MGB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

BASED ON AVAILABLE INFO, DEVICE MALFUNCTION COULD NOT BE IDENTIFIED. REVIEW OF THE DEVICE HISTORY RECORD FOR THIS LOT DID NOT PRODUCE ANY FINDINGS THAT ATTRIBUTED TO THIS INCIDENT. WE HAVE IDENTIFIED A COMPLAINT THAT HAS MET THE CRITERIA FOR REPORTABLILITY. SUBSEQUENTLY, WE HAVE DETERMINED THAT THIS EVENT IS REPORTABLE AS AN ADVERSE EVENT.

Description of Event or Problem · 1

A PHYSICIAN ATTEMPTED AN ARTERIOTOMY CLOSURE USING THE STARCLOSE DEVICE. THE THUMB ADVANCER COULD NOT BE PUSHED TO ITS FINAL POSITION BEFORE CLIP DEPLOYMENT. THE PHYSICIAN PRESSED THE SAFETY RELEASE BUTTON AND THE VESSEL LOCATOR WINGS DID NOT RETRACT. THE DEVICE WAS REMOVED FROM THE PT WITH THE VESSEL LOCATER WINGS DEPLOYED. IT WAS OBSERVED THAT THE CLIP WAS BENT AND PLASTIC FROM THE INNER SHEATH WAS IN A LUMP TOWARDS THE TIP OF THE DEVICE. THE PHYSICIAN REVERTED TO MANUAL COMPRESSION TO ACHIEVE HEMOSTASIS. THERE WAS NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STARCLOSE VASCULAR CLOSURE SYSTEM VASCULAR CLOSURE SYSTEM MGB ABBOTT VASCULAR INC. NA 25026

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other