VASCLIP *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2007-01-10 for VASCLIP * manufactured by Vmbc, Llc.

Event Text Entries

[549155] I had a vasectomy performed in 2005. This vasectomy was performed using a device known as vasclip which is manufactured, marketed and distributed by vmbc llc of 3564 rollingview drive, suite h, white bear lake, minnesota, 55110. Telephone numbers tel: 651. 631. 1830 fax; 651. 631. 1850 and website www. Vasclip. Com. I researched this device for approx six months before deciding to have the procedure peformed with this device. Its proported advantage to a traditional vasectomy were 100% effectiveness with reducted pain and inflammation due to less actual tissue cutting than a traditional vasectomy. I performed the required testing post procedure per facility's protocols and was declared sterile 5 months later. In 2007, my wife informed me she was pregnant. This caused extreme stress in our relationship as we were informed that this could not be possible if i was the partner. I had a semen analysis performed in 2007 and it was positive for sperm. I was immediately examined thoroughly by dr and he confirmed the clips were in place as he had placed them and that i was indeed passing sperm in my semen. He could not explain this and was accordingly astonished that the device had indeed failed. I was told my options were to have a traditional vasectomy -at no cost to myself- and that he was very sorry about the pregnancy. I raised two concerns: #1 did having a second vasectomy expose me to greater risk for complications, which he indicated it should not. #2 i raised concerns that all other vasclip pts should be notified of possible product failure as this has been a catastrophic event in my wife's and my life. Dr said that he would research on some type of reporting mechanism for this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1041590
MDR Report Key803655
Date Received2007-01-10
Date of Report2007-01-10
Date of Event2007-01-09
Date Added to Maude2007-01-16
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameVASCLIP
Generic NameVASCLIP
Product CodeNJC
Date Received2007-01-10
Model Number*
Catalog Number*
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age*
Implant FlagY
Date Removed*
Device Sequence No1
Device Event Key791160
ManufacturerVMBC, LLC
Manufacturer Address3564 ROLLINGVIEW DR WHITE BEAR LAKE MN 55110 US


Patients

Patient NumberTreatmentOutcomeDate
101. Congenital Not Applicablenomaly; 2. Other; 3. Deathisabilit 2007-01-10

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