FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2100447 · Received May 17, 2011

Report

Report Number
9612164-2011-00433
Event Type
Injury
Date Received
May 17, 2011
Date of Event
March 18, 2008
Report Date
April 18, 2011
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060033
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

TWO ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG ELUTING STENTS WERE IMPLANTED IN THE MID LCX DURING THE INDEX PROCEDURE. EVENT WAS IDENTIFIED BY THE CLINICAL EVENTS COMMITTEE AND DEEMED TO BE CONSISTENT WITH AN MI. IT WAS REPORTED THAT AN MI OCCURRED ONE DAY POST STENT IMPLANT. MI WAS CATEGORIZED AS A NON Q WAVE MI, IN THE TERRITORY OF THE TARGET VESSEL. NO FURTHER DETAILS ARE AVAILABLE. PT WAS ASYMPTOMATIC / FREE OF SYMPTOMS AT 30 DAY, 6 MONTH, 1.5 YEAR, 2.5 YEAR AND 3 YEAR FOLLOW UPS. PT'S CURRENT CARDIAC STATUS AT 1 YEAR AND 2 YEAR FOLLOW UPS WAS UNSTABLE ANGINA. (REF MFR # 9612164-2011-00432).

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 52 YR Hospitalization CLOPIDOGREL| ASPIRIN AND