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U.S. Department of Health and Human Services

TPLC - Total Product Life Cycle

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Device hemostatic device for endoscopic gastrointestinal use
Regulation Description Hemostatic device for intraluminal gastrointestinal use.
Definition Hemostatic device for intraluminal gastrointestinal use. A hemostatic device for intraluminal gastrointestinal use is a prescription device that is endoscopically applied to the upper and/or lower gastrointestinal tract and is intended to produce hemostasis via absorption of fluid or by other physical means.
Product CodeQAU
Regulation Number 878.4456
Device Class 2


Premarket Reviews
ManufacturerDecision
3-D MATRIX EUROPE SAS
  SUBSTANTIALLY EQUIVALENT 2
3-D MATRIX, INC.
  SUBSTANTIALLY EQUIVALENT 2
ENDOCLOT PLUS CO., LTD.
  SUBSTANTIALLY EQUIVALENT 1
HEMOSTASIS, LLC
  SUBSTANTIALLY EQUIVALENT 1
NEXTBIOMEDICAL CO., LTD.
  SUBSTANTIALLY EQUIVALENT 2

MDR Year MDR Reports MDR Events
2021 112 112
2022 135 135
2023 132 132
2024 154 154
2025 126 126
2026 11 11

Device Problems MDRs with this Device Problem Events in those MDRs
Activation Failure 469 469
Obstruction of Flow 77 77
Complete Blockage 63 63
Adverse Event Without Identified Device or Use Problem 58 58
Fracture 52 52
Device Handling Problem 46 46
Entrapment of Device 34 34
Improper or Incorrect Procedure or Method 22 22
Material Twisted/Bent 18 18
Insufficient Flow or Under Infusion 10 10
Failure to Disconnect 9 9
Insufficient Information 6 6
Failure to Fire 5 5
Infusion or Flow Problem 4 4
Off-Label Use 3 3
Device Damaged by Another Device 3 3
Detachment of Device or Device Component 3 3
Human-Device Interface Problem 3 3
Defective Device 2 2
Therapeutic or Diagnostic Output Failure 2 2
Failure to Deliver 2 2
Extra Components 2 2
Activation, Positioning or Separation Problem 1 1
Material Split, Cut or Torn 1 1
Break 1 1
Physical Resistance/Sticking 1 1
Accessory Incompatible 1 1
Patient-Device Incompatibility 1 1
Difficult to Insert 1 1
Use of Device Problem 1 1
Component Missing 1 1
Gas/Air Leak 1 1
Inaccurate Flow Rate 1 1
Component Misassembled 1 1
Mechanical Jam 1 1
Premature Activation 1 1

Patient Problems MDRs with this Patient Problem Events in those MDRs
No Clinical Signs, Symptoms or Conditions 523 523
Gastrointestinal Hemorrhage 101 101
Device Embedded In Tissue or Plaque 26 26
Hemorrhage/Bleeding 15 15
Pain 10 10
Insufficient Information 8 8
Perforation 7 7
No Consequences Or Impact To Patient 6 6
No Known Impact Or Consequence To Patient 4 4
Foreign Body Sensation in Eye 2 2
Abdominal Pain 2 2
Hypersensitivity/Allergic reaction 2 2
Abdominal Distention 2 2
Laceration(s) of Esophagus 2 2
Cardiac Arrest 2 2
Unspecified Tissue Injury 2 2
Bruise/Contusion 2 2
High Blood Pressure/ Hypertension 1 1
Appropriate Clinical Signs, Symptoms, Conditions Term / Code Not Available 1 1
Respiratory Arrest 1 1
Adult Respiratory Distress Syndrome 1 1
Perforation of Esophagus 1 1
Embolism/Embolus 1 1
Exsanguination 1 1
Local Reaction 1 1
Obstruction/Occlusion 1 1
Anaphylactoid 1 1
Foreign Body In Patient 1 1
Fever 1 1
Hematemesis 1 1
Laceration(s) 1 1
Cough 1 1
Pseudoaneurysm 1 1
Ruptured Aneurysm 1 1
Hypoxia 1 1
Eye Pain 1 1
Unspecified Vascular Problem 1 1
Inadequate Pain Relief 1 1

Recalls
Manufacturer Recall Class Date Posted
1 Wilson-Cook Medical Inc. II Dec-02-2024
2 Wilson-Cook Medical Inc. II Oct-16-2024
3 Wilson-Cook Medical Inc. II Jun-21-2023
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