FDA Adverse Event Injury Summary report: N

TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM

MDR report key: 1171189 · Received September 22, 2008

Report

Report Number
2134265-2008-02693
Event Type
Injury
Date Received
September 22, 2008
Report Date
September 2, 2008
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
NIQ
PMA / PMN Number
P030025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE ANALYSIS. AS NO DEVICE WAS RECEIVED FOR ANALYSIS IT IS NOT POSSIBLE TO PERFORM ANY INSPECTIONS ON THE DEVICE. THE MANUFACTURING RECORDS HAVE BEEN REVIEWED AND NO ISSUES OR DISCREPANCIES WERE FOUND. THIS RECORDS REVIEW CONFIRMS THAT THE DEVICE MET ALL MATERIAL, ASSEMBLY, AND PERFORMANCE SPECIFICATIONS. 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 THAT POST A CORONARY DRUG ELUTING STENTING TREATMENT PROCEDURE, STENT THROMBOSIS AND/OR MYOCARDIAL INFARCTION OCCURRED. THE PHYSICIAN IMPLANTED A 2.50X24MM TAXUS EXPRESS2 STENT IN AN UNSPECIFIED LOCATION. AN UNKNOWN AMOUNT OF TIME LATER, THE PATIENT SUFFERED A STENT THROMBOSIS AND/OR A MYOCARDIAL INFARCTION. FURTHER INFORMATION HAS BEEN REQUESTED BUT HAS NOT BEEN PROVIDED.

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 CORPORATION 2.50X24MM 7575622

Patients

Seq Age Sex Outcome Treatment
1 Other