FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2172663 · Received July 20, 2011

Report

Report Number
9612164-2011-00789
Event Type
Injury
Date Received
July 20, 2011
Date of Event
March 17, 2011
Report Date
July 9, 2012
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

IT WAS CONFIRMED THAT THE 1ST OBTUSE MARGINAL WAS STENTED DURING THE INDEX PROCEDURE AND NOT THE LCX AS INITIALLY REPORTED.

Description of Event or Problem · 1

DURING INDEX PROCEDURE THE PATIENT HAD ONE ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG-ELUTING STENT IMPLANTED TO THE PROXIMAL CIRCUMFLEX AND ONE ENDEAVOR SPRINT RX DRUG-ELUTING STENT IMPLANTED TO THE PROXIMAL LAD. THE PATIENT SUFFERED A MYOCARDIAL INFARCTION (MI) ON THE SAME DAY. THE REPORTED MI WAS RELATED TO THE TARGET VESSEL. THE INVESTIGATOR INDICATED THAT THE EVENT WAS DEFINITELY RELATED TO THE STUDY DEVICE. PATIENT ASYMPTOMATIC AT 30 DAY AND 3 MONTH FOLLOW-UP. (REF # 9612164201100788).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0001141326

Patients

Seq Age Sex Outcome Treatment
1 58 YR Hospitalization ASA AT TIME OF EVENTS.| CLOPIDOGREL AND| THE PATIENT WAS TAKING NITRATE,