FDA Adverse Event Death Summary report: N

MULTI-LINK CORONARY STENT SYSTEM

MDR report key: 3021880 · Received March 26, 2013

Report

Report Number
2024168-2013-01736
Event Type
Death
Date Received
March 26, 2013
Date of Event
March 1, 2013
Report Date
March 1, 2013
Manufacturer
AV-TEMECULA-CT
Product Code
MAF
PMA / PMN Number
P970020
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MT, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE REMAINS IN THE PATIENT. INVESTIGATION IS NOT YET COMPLETE. A FOLLOW-UP REPORT WILL BE SUBMITTED WITH ALL ADDITIONAL RELEVANT INFORMATION.

Additional Manufacturer Narrative · 1

(B)(4). THERE WAS NO REPORTED PRODUCT DEFICIENCY AND THE PRODUCT WAS NOT RETURNED. THE REPORTED PATIENT EFFECT OF DEATH, AS LISTED IN THE MULTI-LINK VISION CORONARY STENT SYSTEMS ELECTRONIC INSTRUCTIONS FOR USE, IS A KNOWN ADVERSE EVENT ASSOCIATED WITH CORONARY STENTING PROCEDURES. ALTHOUGH A CONCLUSIVE CAUSE FOR THE REPORTED PATIENT EFFECT AND THE RELATIONSHIP TO THE DEVICE, IF ANY, CANNOT BE DETERMINED, THERE IS NO INDICATION OF A PRODUCT QUALITY DEFICIENCY WITH RESPECT TO MANUFACTURE, DESIGN OR LABELING.

Description of Event or Problem · 1

IT WAS REPORTED THAT A STAFF MEMBER AT THE ACCOUNT STATED THAT RECENTLY DURING AN UNSPECIFIED STENTING PROCEDURE, THE PATIENT EXPIRED. THE PHYSICIAN BELIEVED THERE WAS A CONNECTION TO THE PATIENT'S HEPARIN MEDICATION, BUT NOW BELIEVES THE CONNECTION MIGHT BE TO THE STENTING PROCEDURE. IT WAS ALSO REPORTED THAT RECENTLY, THERE WERE TWO OTHER UNSPECIFIED STENTS THAT HAD THROMBOSIS. THERE WAS NO ADVERSE PATIENT EFFECT. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
124670 MULTI-LINK CORONARY STENT SYSTEM CORONARY STENT SYSTEM MAF AV-TEMECULA-CT

Patients

Seq Age Sex Outcome Treatment
1 Death