FDA Adverse Event Death Summary report: N

TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM

MDR report key: 2005414 · Received March 2, 2011

Report

Report Number
2134265-2011-00754
Event Type
Death
Date Received
March 2, 2011
Date of Event
October 5, 2010
Report Date
February 4, 2011
Manufacturer
BOSTON SCIENTIFIC - MAPLE GROVE
Product Code
NIQ
PMA / PMN Number
P030025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE IS A COMBINATION PRODUCT. IT IS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. A REVIEW OF THE BATCH HISTORY, HISTORICAL TRENDING, AND SIMILAR COMPLAINT TRENDING REVIEW FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED INDICATED THE PATIENT WAS IN CARDIOPULMONARY ARREST UPON ARRIVAL AT THE HOSPITAL BUT WAS UNABLE TO BE REVIVED.

Description of Event or Problem · 1

SAME CASE AS MFR REPORT #: 2134265-2011-00753. TAXUS EXPRESS2 (B)(4) POST MARKET SURVEILLANCE STUDY. IT WAS REPORTED THAT FOLLOWING A CORONARY ARTERY STENTING TREATMENT PROCEDURE, THE PATIENT EXPIRED. THE INDEX PROCEDURE TREATED TWO TARGET LESIONS. TARGET LESION ONE WAS IN THE 2.5MM, 90% STENOSED RIGHT POSTERIOR ATRIOVENTRICULAR (R-PAV) ARTERY. TREATMENT CONSISTED OF DIRECT STENTING USING A 2.5X8MM TAXUS EXPRESS2 STENT DEPLOYED AT 10ATM RESULTING IN 0% STENOSIS AND GOOD IMPLANTATION AFTER IVUS (INTRAVASCULAR ULTRASOUND). TARGET LESION TWO WAS 2.0X10MM WITH 99% STENOSIS OF THE RIGHT POSTERIOR DESCENDING ARTERY (R-PDA). TREATMENT CONSISTED OF PREDILATION WITH A 2.0X10MM BALLOON AT 6ATM AND PLACEMENT OF A 2.5X16MM TAXUS EXPRESS2 STENT DEPLOYED AT 16ATM RESULTING IN 0% RESIDUAL STENOSIS AND GOOD IMPLANTATION AFTER IVUS. BOTH LOCATIONS HAD TIMI 3 FLOW POST STENTING. IN (B)(6) 2010, THE PATIENT'S FAMILY WAS UNABLE TO WAKE THE PATIENT. THE PATIENT WAS TRANSPORTED TO THE HOSPITAL BY AMBULANCE BUT WAS UNABLE TO BE REVIVED. NO AUTOPSY WAS PERFORMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM CORONARY DRUG-ELUTING STENT NIQ BOSTON SCIENTIFIC - MAPLE GROVE H7493897016250 9581272

Patients

Seq Age Sex Outcome Treatment
1 79 YR Death