FDA Adverse Event Death Summary report: N

WINGSPAN STENT SYSTEM

MDR report key: 1363036 · Received April 13, 2009

Report

Report Number
2939204-2009-00315
Event Type
Death
Date Received
April 13, 2009
Report Date
March 23, 2009
Manufacturer
NEUROVASCULAR DIV, BOSTON SCIENTIFIC CORP
Product Code
NJE
PMA / PMN Number
H050001
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DATE OF DEATH: EXACT DATE IS UNK, ALL PTS IN THE REGISTRY WERE TREATED BETWEEN 2005 AND 2006. DATE OF EVENT: EXACT DATE IS UNK, ALL PTS IN THE REGISTRY WERE TREATED BETWEEN 2005 AND 2006. UNK AS THE UPN AND BATCH NUMBERS WERE NOT DISCLOSED. DATE OF IMPLANT: EXACT DATE IS UNK, ALL PTS IN THE REGISTRY WERE TREATED BETWEEN 2005 AND 2006. OTHER FOR NO ALLEGATION OF PRODUCT MALFUNCTION OR NON CONFORMANCE CONTRIBUTING TO THE REPORTED EVENT. REPORT SOURCE: NEUROLOGY. 2008;70(17) :1518-24 AND NEUROLOGY. 2009. [EPUB AHEAD OF PRINT].

Description of Event or Problem · 1

THIS EVENT WAS REPORTED IN AN ARTICLE FROM A NATIONAL INSTITUTE OF HEALTH REGISTRY TO INVESTIGATE THE SUCCESS OF TREATING PTS WITH 50% TO 99% STENOSIS WITH ANGIOPLASTY AND A SINGLE INTRACRANIAL STENT. THIS REPORT IS FOR A PT, WITH 70% TO 99% STENOSIS, WHO DIED WITHIN TWENTY FOUR HOURS OF THE PROCEDURE, CONSIDERED TO BE PERI-PROCEDURE BY THE STUDY, DUE TO A PONTINE HEMORRHAGE. NO OTHER INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 WINGSPAN STENT SYSTEM NJE NEUROVASCULAR DIV, BOSTON SCIENTIFIC CORP UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 Death GATEWAY PTA BALLOON CATHETER (MODEL UNK| SCIENTIFIC)