FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2172661 · Received July 20, 2011

Report

Report Number
9612164-2011-00792
Event Type
Injury
Date Received
July 20, 2011
Date of Event
June 2, 2011
Report Date
June 29, 2011
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060033
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: (MYOCARDIAL INFARCTION).

Description of Event or Problem · 1

DURING INDEX PROCEDURE THE PATIENT HAD ONE ENDEAVOR SPRINT RAPID EXCHANGED (RX) DRUG-ELUTING STENT IMPLANTED TO THE MID CIRCUMFLEX. THE PATIENT SUFFERED AN MI THE FOLLOWING DAY. THE REPORTED MI WAS RELATED TO THE TARGET VESSEL. ONE WEEK LATER, DURING A STAGED PROCEDURE, THE PATIENT HAD TWO ENDEAVOR SPRINT RX DRUG-ELUTING STENTS IMPLANTED TO THE DISTAL RCA ON THE SAME DAY AN MI OCCURRED. THE REPORTED MI WAS RELATED TO THE TARGET VESSEL. THE INVESTIGATOR INDICATED THAT BOTH EVENTS WERE RELATED TO THE STUDY DEVICE. (REF MFR # 9612164-2011-00790 AND 9612164-2011-00791).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0003354674

Patients

Seq Age Sex Outcome Treatment
1 58 YR Hospitalization ACE,| CLOPIDOGREL AND| ASA AT TIME OF EVENTS.| LIPID LOWERING DRUGS,| THE PATIENT WAS TAKING BETA-BLOCKER,| NITRATE,