FDA Adverse Event Injury Summary report: N

TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM

MDR report key: 2042522 · Received April 6, 2011

Report

Report Number
2134265-2011-01216
Event Type
Injury
Date Received
April 6, 2011
Date of Event
December 3, 2009
Report Date
March 9, 2011
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
NIQ
PMA / PMN Number
P030025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

DEVICE IS A COMBINATION PRODUCT. DEVICE EVALUATED BY MANUFACTURER. 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).

Description of Event or Problem · 1

(B)94). SAME CASE AS 2134265-2011-01217 AND 2134265-2011-01218. IT WAS REPORTED THAT FOLLOWING A CORONARY ARTERY STENTING TREATMENT PROCEDURE RESTENOSIS OCCURRED. THE DENOVO LESION WAS 75% STENOSIS, 40MM LONG WITH A DIAMETER OF 2.75. PRE-DILATATION WAS PERFORMED WITH 2.5X15MM BALLOON (12 ATM). THE PHYSICIAN THEN IMPLANTED THREE (2.5X24MM, 2.75X32MM AND 3.0X16MM) TAXUS EXPRESS2 STENTS IN THE TARGET LESION. NO POST-DILATATION WAS PERFORMED, RESIDUAL STENOSIS WAS 0% WITH TIMI FLOW 3. THE PATIENT WAS DISCHARGED ON PLAVIX, PLETAAL AND BAYASPIRIN. AT THE FOLLOW-UP VISIT IN (B)96) 2009, RESTENOSIS WAS CONFIRMED. THE ANGIOGRAPHY SHOWED THE LESION WAS 75% STENOSED, 10.0MM LONG WITH A DIAMETER OF 3.0MM. PCI WITH BALLOONING WAS PERFORMED. RESIDUAL STENOSIS WAS 0% WITH TIMI FLOW 3. THE PATIENT WAS DISCHARGED 2 DAYS LATER.

Description of Event or Problem · 1

IT WAS FURTHER REPORTED THAT THE LESION BEING TREATED IN THE INDEX PROCEDURE WAS LOCATED IN THE MID LEFT ANTERIOR DESCENDING ARTERY.

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 - GALWAY H7493897024250 0011055553

Patients

Seq Age Sex Outcome Treatment
1 73 YR Required Intervention 2.75X32MM TAXUS EXPRESS2 STENT| 3.00X16MM TAXUS EXPRESS2 STENT