FDA Adverse Event Injury Summary report: N

TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM

MDR report key: 1081433 · Received July 25, 2008

Report

Report Number
2134265-2008-02104
Event Type
Injury
Date Received
July 25, 2008
Report Date
June 26, 2008
Manufacturer
BOSTON SCIENTIFIC
Product Code
NIQ
PMA / PMN Number
P030025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AS NO DEVICE WAS RECEIVED FOR ANALYSIS, IT IS NOT POSSIBLE TO PERFORM ANY INSPECTIONS ON THE DEVICE. THEREFORE, IT IS NOT POSSIBLE TO DETERMINE IF ANY ISSUES EXISTED WITH THE ACTUAL UNIT THAT COULD HAVE CONTRIBUTED TO THE COMPLAINT. AS THE BATCH NUMBER IS UNKNOWN, A REVIEW OF THE MANUFACTURING RECORDS COULD NOT BE CARRIED OUT. THE ROOT CAUSE WILL BE DOCUMENTED AS ANTICIPATED PROCEDURAL COMPLICATION, DUE TO A KNOWN PHYSIOLOGICAL EFFECT OF THE PROCEDURE NOTED WITHIN THE DIRECTIONS FOR USE, AND/OR DEVICE LABELING.

Description of Event or Problem · 1

IT WAS REPORTED BY THE PATIENT, THAT POST A CORONARY DRUG ELUTING STENTING TREATMENT PROCEDURE, LATE STENT THROMBOSIS OCCURRED. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM NIQ STENT, CORONARY, DRUG-ELUTING NIQ BOSTON SCIENTIFIC

Patients

Seq Age Sex Outcome Treatment
1 Other