FDA Adverse Event Injury Summary report: N

ENDEAVOR SPRINT RX

MDR report key: 3001984 · Received March 13, 2013

Report

Report Number
9612164-2013-00280
Event Type
Injury
Date Received
March 13, 2013
Date of Event
January 6, 2013
Report Date
April 2, 2014
Manufacturer
MEDTRONIC IRELAND
Product Code
NIQ
PMA / PMN Number
P060033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

RESULTS: MYOCARDIAL INFARCTION. CONCLUSIONS: MYOCARDIAL INFARCTION. (B)(4).

Description of Event or Problem · 1

DURING THE INDEX PROCEDURE, THE ENDEAVOR SPRINT DRUG ELUTING STENT WAS IMPLANTED IN THE LAD.

Description of Event or Problem · 1

PATIENT RECEIVED AN ENDEAVOR SPRINT RX DURING INDEX PROCEDURE. HOWEVER IT WAS REPORTED THAT THE PATIENT SUFFERED AN MI SOME TIME POST PROCEDURE. IT IS UNKNOWN IF IT WAS RELATED TO THE TARGET VESSEL. THE INVESTIGATOR ASSESSED THAT THE EVENT WAS POSSIBLY RELATED TO THE STUDY DEVICE. THE PATIENT RECOVERED. NO OTHER CLINICAL SEQUELAE WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
105165 ENDEAVOR SPRINT RX STENT, CORONARY, DRUG-ELUTING NIQ MEDTRONIC IRELAND

Patients

Seq Age Sex Outcome Treatment
1 00069 YR Hospitalization PLAVIX AND ASPIRIN