FDA Adverse Event Other Summary report: N

STARCLOSE VASCULAR CLOSURE SYSTEM

MDR report key: 959961 · Received April 25, 2007

Report

Report Number
2953144-2007-00544
Event Type
Other
Date Received
April 25, 2007
Date of Event
August 28, 2005
Report Date
September 28, 2005
Manufacturer
ABBOTT VASCULAR INC.
Product Code
MGB
Removal / Correction Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
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 REPORTABILITY. 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 PHYSICIAN SUCCESSFULLY ACHIEVED CLOSURE, BUT THE END OF SHEATH SHEARED. THERE WAS NO FURTHER INFO AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STARCLOSE VASCULAR CLOSURE SYSTEM VASCULAR CLOSURE SYSTEM MGB ABBOTT VASCULAR INC. NA 27085

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other