FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2023550 · Received March 16, 2011

Report

Report Number
9612164-2011-00049
Event Type
Injury
Date Received
March 16, 2011
Date of Event
November 5, 2010
Report Date
February 14, 2011
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060033
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION: RESULTS: (MI). CONCLUSIONS: NO CONCLUSION COULD BE DRAWN.

Description of Event or Problem · 1

THE PT HAD AN ENDEAVOR SPRINT STENT IMPLANTED THE PROX LAD. THE DAY AFTER THE INDEX PROCEDURE, THE PT SUFFERED HYPERTENSION AND BRADYCARDIA AND RECOVERED WITHOUT TREATMENT. TWO DAYS AFTER INDEX PROCEDURE, THE PT SUFFERED FROM ANGINA AND RECOVERED WITHOUT TREATMENT. ONE MONTH AFTER THE INDEX PROCEDURE, THE PT SUFFERED FROM DULL BACK AND SHOULDER PAIN AND RECOVERED WITHOUT TREATMENT. A YEAR AND TWO MONTHS AFTER THE INDEX PROCEDURE, THE PT HAD AN ENDEAVOR SPRINT STENT IMPLANTED IN THE PROX RCA. ONE AND 6 MONTHS FROM THE INDEX PROCEDURE, THE PT HAD ANOTHER STENT IMPLANTED IN THE MID LAD. CEC COMMENTS: MI DURING THE INDEX PROCEDURE OR RE-PCI, NON Q-WAVE MI NOT IN THE TERRITORY OF THE TARGET VESSEL; SIDE BRANCH OCCLUSION, PERIPROCEDURAL MI DUE TO THE LOSS OF THE SIDE BRANCH DURING PCI TO LAD. (REF MFR REPORT NUMBER 9612164-2011-00050).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0000520195

Patients

Seq Age Sex Outcome Treatment
1 71 YR Hospitalization