FDA Adverse Event Death Summary report: N

ENDEAVOR RX CORONARY STENT SYSTEM

MDR report key: 1712896 · Received June 4, 2010

Report

Report Number
2953200-2010-01044
Event Type
Death
Date Received
June 4, 2010
Date of Event
November 29, 2009
Report Date
May 7, 2010
Manufacturer
MEDTRONIC CARDIOVASCULAR GALWAY
Product Code
NIQ
PMA / PMN Number
P060033
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B) (4). RESULTS: MYOCARDIAL INFARCTION.

Description of Event or Problem · 1

EVENT WAS IDENTIFIED BY THE CLINICAL EVENTS COMMITTEE AND DEEMED TO BE CONSISTENT WITH AN MI. FOUR ENDEAVOR RAPID EXCHANGE (RX) DRUG-ELUTING STENTS WERE IMPLANTED ONE IN THE DISTAL LAD, ONE IN THE DISTAL LCX, ONE IN THE PROXIMAL RCA AND ONE IN THE MID RCA. (REF MFR# 2953200-2010-01043, 2953200-2010-01045, 2953200-2010-01046). IT WAS REPORTED THAT AN MI OCCURRED ONE DAY POST STENT IMPLANT. MI WAS CATEGORIZED AS A NON Q WAVE MI, IN THE TERRITORY OF THE IMPLANTED STENT. NO FURTHER DETAILS ARE AVAILABLE. AT 1 MONTH, 6 MONTH, 1 YEAR AND 1.5 YEAR FOLLOW-UPS PT WAS ASYMPTOMATIC / FREE OF SYMPTOMS. IT WAS REPORTED THAT THE PT EXPIRED 21.5 MONTHS POST INDEX PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR RX CORONARY STENT SYSTEM NIQ MEDTRONIC CARDIOVASCULAR GALWAY NA 0000411962

Patients

Seq Age Sex Outcome Treatment
1 54 YR Death ASA| CLOPIDOGREL| 24 HOURS BEFORE EVENT