FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2172675 · Received July 20, 2011

Report

Report Number
9612164-2011-00797
Event Type
Injury
Date Received
July 20, 2011
Date of Event
June 22, 2011
Report Date
March 5, 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).

Additional Manufacturer Narrative · 1

CORRECTION TO EVENT DATE - DATE OF EVENT HAS BEEN CONFIRMED AS (B)(6) 2011 AND NOT (B)(6) 2011 AS PREVIOUSLY 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 LAD AND ONE ENDEAVOR SPRINT RX DRUG-ELUTING STENT IMPLANTED TO THE MID LAD. A LATERAL BRANCH OCCLUSION OCCURRED DURING PROXIMAL LAD IMPLANTATION. ON THE SAME DAY THE PATIENT SUFFERED A MYOCARDIAL INFARCTION (MI). THE MI WAS NOT RELATED TO THE TARGET VESSEL. THE INVESTIGATOR INDICATED THAT THE REPORTED EVENT WAS NOT RELATED TO THE STUDY DEVICE. (REF MFR #9612164-2011-00796).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0003134629

Patients

Seq Age Sex Outcome Treatment
1 60 YR Hospitalization LIPID LOWERING DRUGS| THE PATIENT WAS TAKING BETA-BLOCKERS,| DIURETIC,| ACE INHIBITOR,| ASA AT TIME OF EVENT.| CLOPIDOGREL AND| NITRATE,