FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 1983035 · Received February 7, 2011

Report

Report Number
2953200-2011-00293
Event Type
Injury
Date Received
February 7, 2011
Date of Event
January 6, 2011
Report Date
January 11, 2011
Manufacturer
MEDTRONIC CARDIOVASCULAR GALWAY
Product Code
NIQ
PMA / PMN Number
K060033
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION, RESULTS: MI.

Description of Event or Problem · 1

A 3.5 MM DIAMETER X 24 MM LENGTH ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG ELUTING CORONARY STENT WAS DEPLOYED IN THE MID RCA OF A PATIENT. DURING PROCEDURE, THE PATIENT ALSO RECEIVED ONE 2.25 MM DIAMETER X 30 MM LENGTH (REF MFR # 2953200-2011-00294) ENDEAVOR SPRINT RX IN THE PROX CX. NO ISSUES HAVE BEEN REPORTED DURING STENT DEPLOYMENT; HOWEVER, IT WAS REPORTED THAT THE PATIENT HAD AN MI ONE DAY POST IMPLANT OF THE RELEVANT STENT. IT WAS REPORTED THAT THE PATIENT WAS ASYMPTOMATIC ON DISCHARGE 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 0001028938

Patients

Seq Age Sex Outcome Treatment
1 70 YR Required Intervention CLOPIDOGREL| ASA