FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX CORONARY STENT SYSTEM

MDR report key: 2251312 · Received September 13, 2011

Report

Report Number
9612164-2011-01141
Event Type
Injury
Date Received
September 13, 2011
Date of Event
August 23, 2011
Report Date
August 29, 2011
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060023
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).

Description of Event or Problem · 1

DURING INDEX PROCEDURE, THE PT HAD TWO ENDEAVOR SPRINT RAPID EXCHANGE (RX) DRUG-ELUTING STENTS IMPLANTED TO THE PROXIMAL CIRCUMFLEX. ON THE SAME DAY THE PT SUFFERED A MYOCARDIAL INFARCTION (MI). THE MI WAS NOT RELATED TO THE TARGET VESSEL. THE INVESTIGATOR INDICATED THE REPORTED EVENT WAS POSSIBLY TO THE STUDY DEVICE. (REF MFR #9612164-2011-01140).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX CORONARY STENT SYSTEM NIQ MEDTRONIC IRELAND NA 0005510617

Patients

Seq Age Sex Outcome Treatment
1 54 YR Hospitalization DIURETICS| ACE INHIBITOR| THE PT WAS TAKING BETA-BLOCKERS| ASA AT THE TIME OF EVENT.| CLOPIDOGREL| LIPID LOWERING DRUGS