FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 1924215 · Received December 7, 2010

Report

Report Number
2953200-2010-02453
Event Type
Injury
Date Received
December 7, 2010
Date of Event
November 10, 2010
Report Date
November 25, 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).

Additional Manufacturer Narrative · 1

CLOPIDOGREL AND ASA.

Description of Event or Problem · 1

THE PT REC'D A 3.0MM DIAMETER X 18MM LENGTH ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG ELUTING CORONARY STENT IN THE PROX RCA (REF MFR # 2953200-2010-02452), A 3.0MM DIAMETER X 24MM LENGTH ENDEAVOR SPRINT RX STENT IN THE MID RCA, A 3.5MM DIAMETER X 30MM LENGTH AND A 3.0MM DIAMETER X 12MM LENGTH ENDEAVOR SPRINT RX STENTS IN THE PROX LAD (REF MFR # 2953200-2010-02454 AND MFR # 2953200-2010-02455) DURING INDEX PROCEDURE. IMPLANT OF THE STENTS WAS SUCCESSFUL; HOWEVER, IT WAS REPORTED THAT THE PT HAD AN MI ONE DAY POST IMPLANT. NO OTHER CLINICAL SEQUELAE WERE REPORTED.

Description of Event or Problem · 1

IT IS UNKNOWN WHETHER THE REPORTED MI WAS RELATED TO THE TARGET VESSEL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC CARDIOVASCULAR GALWAY NA 0001060403

Patients

Seq Age Sex Outcome Treatment
1 71 YR BETA, CA++ ANTAGONIST, LIPID LOWERING DRUGS