VENA SEAL CLOSURE SYSTEM VS-402

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-02-03 for VENA SEAL CLOSURE SYSTEM VS-402 manufactured by Medtronic Ireland.

Event Text Entries

[177361585] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[177361586] Patient received venaseal treatment of the great saphenous vein (gsv). 11 segments were treated, and the vein is reported to have closed. Procedure was completed as per ifu. It is reported the patient reported 9-10 days post implant with redness along the treated vein tract. The physician instructed the patient to use warm compresses and nsaids to treat. It is reported the symptoms continued to get worse with redness spreading to the abdomen and opposite thigh. The treating physician then prescribed a course of steroids to treat the hypersensitivity. At this time symptoms have improved.
Patient Sequence No: 1, Text Type: D, B5


[182473241] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[182473854] Additional information: the patient's condition has fully resolved and is doing well with no issues. No further patient injury. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[188585734] Additional information: the left gsv was treated and 1. 8cc of venaseal were used to treat the vessel. The hypersensitivity is almost fully resolved. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9612164-2020-00518
MDR Report Key9659026
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-02-03
Date of Report2020-03-05
Date of Event2020-01-24
Date Mfgr Received2020-03-03
Device Manufacturer Date2019-01-15
Date Added to Maude2020-02-03
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactTONI O'DOHERTY
Manufacturer StreetPARKMORE BUSINESS PARK WEST
Manufacturer CityGALWAY
Manufacturer Phone091708734
Manufacturer G1MEDTRONIC IRELAND
Manufacturer StreetPARKMORE BUSINESS PARK WEST
Manufacturer CityGALWAY
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVENA SEAL CLOSURE SYSTEM
Generic NameAGENT, OCCLUDING, VASCULAR, PERMANENT
Product CodePJQ
Date Received2020-02-03
Catalog NumberVS-402
Lot Number54320
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC IRELAND
Manufacturer AddressPARKMORE BUSINESS PARK WEST GALWAY


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-02-03

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