FDA Adverse Event Death Summary report: N

ENDEAVOR SPRINT RX

MDR report key: 2843260 · Received November 22, 2012

Report

Report Number
9612164-2012-01689
Event Type
Death
Date Received
November 22, 2012
Date of Event
March 17, 2011
Report Date
March 10, 2014
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

RESULTS: INHERENT RISK OF PROCEDURE (MI, DISSECTION, AND DEATH). (B)(4).

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

DURING THE INDEX PROCEDURE THE PATIENT HAD TWO ENDEAVOR SPRINT DRUG-ELUTING STENTS IMPLANTED IN THE LAD. A DISSECTION IS REPORTED TO HAVE OCCURRED DURING IMPLANTATION OF THE SECOND ENDEAVOR SPRINT STENT. THE INVESTIGATOR DID NOT ASSESS IF THE EVENT WAS RELATED TO THE STUDY DEVICE. IT WAS REPORTED THAT APPROXIMATELY 40 MONTHS POST THE INDEX PROCEDURE THE PATIENT SUFFERED A FATAL MI AND DIED ON THE SAME DAY. THE INVESTIGATOR HAS INDICATED THAT THE MI AND DEATH WERE POSSIBLY RELATED TO THE STUDY STENTS.

Description of Event or Problem · 1

THE PREVIOUSLY REPORTED MI AND DEATH EVENTS OCCURRED APPROXIMATELY 14 MONTHS POST INDEX PROCEDURE NOT 40 MONTHS AS PREVIOUSLY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDEAVOR SPRINT RX STENT, CORONARY, DRUG-ELUTING NIQ MEDTRONIC IRELAND 0003163326

Patients

Seq Age Sex Outcome Treatment
1 00076 YR Death ASPIRIN AND CLOPIDOGREL