FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2181157 · Received July 21, 2011

Report

Report Number
9612164-2011-00820
Event Type
Injury
Date Received
July 21, 2011
Date of Event
July 3, 2011
Report Date
July 5, 2011
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060033
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

PT HAD A 3.0 MM DIAMETER X 15 MM LENGTH ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG-ELUTING STENT IMPLANTED IN THE PROXIMAL LAD DURING A REVASCULARIZATION PROCEDURE. APPROXIMATELY 3 WEEKS LATER, THE PT SUFFERED A CORONARY STENT THROMBOSIS. IT WAS REPORTED THAT THE PT WAS "FOUND TO BE INVOLVED IN STEMI". PT CHANGED FROM PLAVIX TO EFFIENT. THE PT UNDERWENT THROMBOLYTIC THERAPY AND PERCUTANEOUS INTERVENTION. PT RECOVERED WITH TREATMENT AND NO OTHER CLINICAL SEQUELAE WERE REPORTED.

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 53 YR Required Intervention ASPIRIN| CLOPIDOGREL