FDA Adverse Event Other Summary report: N

STARCLOSE SE VASCULAR CLOSURE SYSTEM

MDR report key: 967386 · Received November 5, 2007

Report

Report Number
2953144-2007-00617
Event Type
Other
Date Received
November 5, 2007
Date of Event
March 7, 2007
Report Date
May 4, 2007
Manufacturer
ABBOTT VASCULAR INC
Product Code
MGB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS EXPECTED TO BE RETURNED FOR INVESTIGATION. IT HAS NOT YET BEEN RECEIVED. 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 WITH A SCARCLOSE SE DEVICE AFTER AN INTERVENTIONAL PROCEDURE. THE PHYSICIAN EXPERIENCED DIFFICULTY IN PULLING BACK THE DEVICE, AND A NEEDLE WAS USED TO REMOVE THE DEVICE. THERE WAS NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STARCLOSE SE VASCULAR CLOSURE SYSTEM VASCULAR CLOSURE DEVICE MGB ABBOTT VASCULAR INC NA 46156-6H

Patients

Seq Age Sex Outcome Treatment
1 UNK YR Required Intervention