FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2230853 · Received August 26, 2011

Report

Report Number
9612164-2011-01018
Event Type
Injury
Date Received
August 26, 2011
Date of Event
April 9, 2011
Report Date
January 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). EVAL RESULTS: (MYOCARDIAL INFARCTION).

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED CONFIRMED THAT A 3RD ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG ELUTING STENT WAS IMPLANTED DURING INDEX PROCEDURE. THE STENT WAS IMPLANTED IN THE PROXIMAL LAD. (REF MFR # 9612164201101017, 9612164201101018 AND 9612164201200105).

Description of Event or Problem · 1

DURING INDEX PROCEDURE THE PT HAD ONE ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG-ELUTING STENT IMPLANTED TO THE DISTAL RCA AND ONE ENDEAVOR SPRINT (RX) DRUG-ELUTING STENT IMPLANTED TO THE MID LAD. THE FOLLOWING DAY, THE PT SUFFERED A MYOCARDIAL INFARCTION (MI). THE REPORTED MI IS UNRELATED TO THE TARGET VESSEL. THE INVESTIGATOR INDICATED THAT REPORTED MI WAS UNRELATED TO THE STUDY STENT. (REF MFR # 9612164201101017).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0001011424

Patients

Seq Age Sex Outcome Treatment
1 77 YR Hospitalization ANGIOTENSIN II RECEPTOR ANTAGONIST| BETA-BLOCKERS| CLOPIDOGREL| LIPID LOWERING DRUG| ASA| NITRATE