FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 1901582 · Received November 12, 2010

Report

Report Number
2953200-2010-02227
Event Type
Injury
Date Received
November 12, 2010
Date of Event
October 8, 2010
Report Date
October 15, 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
BR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVAL: RESULTS: (MI).

Description of Event or Problem · 1

A 2.5MM DIAMETER X 30MM LENGTH ENDEAVOR SPRING RAPID EXCHANGE (RX) DRUG-ELUTING CORONARY STENT WAS DEPLOYED IN THE PROX RCA OF A PT. DURING PROCEDURE THE PT ALSO REC'D A 2.75MM DIAMETER X 30MM LENGTH ENDEAVOR SPRINT RX TO TARGET LESION (MFR REP # 2953200-2010-02228). HOWEVER, IT WAS REPORTED THAT THE PT EXPERIENCED AN MI DURING PROCEDURE. PROLONGED HOSPITALIZATION WAS REQUIRED. THE PT IS REPORTED TO BE RECOVERED AND NO OTHER CLINICAL SEQUELAE WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC CARDIOVASCULAR GALWAY NA 001019761

Patients

Seq Age Sex Outcome Treatment
1 35 YR Hospitalization CLOPIDOGREL| ASPIRIN