FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2230619 · Received August 11, 2011

Report

Report Number
9612164-2011-00920
Event Type
Injury
Date Received
August 11, 2011
Date of Event
June 19, 2011
Report Date
July 19, 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). RESULTS: (MYOCARDIAL INFARCTION).

Description of Event or Problem · 1

DURING INDEX PROCEDURE THE PATIENT HAD ONE ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG-ELUTING STENT WAS IMPLANTED TO THE MID LAD AND ONE ENDEAVOR SPRINT RX DRUG-ELUTING STENT IMPLANTED TO THE MID LEFT CIRCUMFLEX. THE FOLLOWING DAY THE PATIENT SUFFERED A MYOCARDIAL INFARCTION (MI). THE MI WAS RELATED TO THE TARGET VESSEL. THE INVESTIGATOR INDICATED THAT THE REPORTED EVENT WAS DEFINITELY RELATED TO THE STUDY STENT. (REF MFR # 9612164201100919).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0005534967

Patients

Seq Age Sex Outcome Treatment
1 59 YR AND ASA AT TIME OF REPORTED EVENT| ACE| THE PATIENT WAS TAKING BETA-BLOCKERS| LIPID LOWERING DRUGS| CLOPIDOGREL