BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

    MDR report key: 2231147 · Received August 26, 2011

    Report

    Report Number
    9612164-2011-01014
    Event Type
    Injury
    Date Received
    August 26, 2011
    Date of Event
    April 1, 2011
    Report Date
    August 2, 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). EVAL: RESULTS: MI.

    Description of Event or Problem · 1

    PT RECEIVED A 3.0MM DIAMETER X 24MM LENGTH ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG ELUTING CORONARY STENT IN THE MID CX. IT WAS REPORTED THAT THE PT SUFFERED AN MI ONE DAY POST PROCEDURE. INVESTIGATOR REPORTED THAT THE EVENT WAS UNRELATED TO THE STUDY STENT, UNRELATED TO THE TARGET VESSEL AND PROBABLY RELATED TO THE PROCEDURE. PT IS REPORTED TO BE RECOVERED AN 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 0001016534

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Hospitalization CLOPIDOGREL| DIURETIC| ASA| BETA