FDA Adverse Event Injury Summary report: N

TAXUS¿ ELEMENT¿

MDR report key: 3023710 · Received March 27, 2013

Report

Report Number
2134265-2013-01782
Event Type
Injury
Date Received
March 27, 2013
Date of Event
February 24, 2011
Report Date
February 27, 2013
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
NIQ
PMA / PMN Number
P100023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(6). DEVICE IS A COMBINATION PRODUCT. DEVICE EVALUATED BY MFR: IT IS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. A REVIEW OF THE BATCH HISTORY, HISTORICAL TRENDING, AND SIMILAR COMPLAINT TRENDING REVIEW FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Description of Event or Problem · 1

(B)(4). SAME CASE AS MDR ID#: 2134265-2013-01781, 2134265-2013-01783, 2134265-2013-01784. IT WAS REPORTED THAT FOLLOWING A CORONARY ARTERY STENTING TREATMENT PROCEDURE, THE PATIENT HAD MYOCARDIAL INFARCTION (MI). IN (B)(6) 2011, THE PATIENT PRESENTED DUE TO STABLE ANGINA (CCS CLASS-3) AND WAS REFERRED FOR CARDIAC CATHETERIZATION. THE 1ST LONG TARGET LESION WAS LOCATED IN THE PROXIMAL LEFT ANTERIOR DESCENDING ARTERY (PROX LAD) AND EXTENDING TO THE MID LAD WITH 90% STENOSIS AND WAS 24MM LONG WITH A REFERENCE VESSEL DIAMETER OF 2.5MM. THE PHYSICIAN TREATED THE LESION WITH PRE-DILATION AND PLACEMENT OF TWO OVERLAPPING TAXUS ELEMENT STENTS OF SIZE 2.50X20MM AND 3.00X32MM, WITH 0% RESIDUAL STENOSIS. THE 2ND TARGET LESION WAS LOCATED IN THE RAMUS INTERMEDIUS WITH 95% STENOSIS AND WAS 24MM LONG WITH A REFERENCE VESSEL DIAMETER OF 2.5MM. THE PHYSICIAN TREATED THE LESION WITH PRE-DILATION AND PLACEMENT OF TWO OVERLAPPING 2.50X20MM TAXUS ELEMENT STENTS, WITH 0% RESIDUAL STENOSIS. ONE DAY POST INDEX PROCEDURE, ELEVATED CARDIAC ENZYME VALUES WERE NOTED AND AN EVENT OF MI WAS REPORTED. THE PATIENT WAS FREE OF SYMPTOMS. THE EVENT WAS CONSIDERED RESOLVED WITH RESIDUAL EFFECTS AND THE PATIENT WAS DISCHARGED ON ASPIRIN AND CLOPIDOGREL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
126069 TAXUS¿ ELEMENT¿ CORONARY DRUG-ELUTING STENT NIQ BOSTON SCIENTIFIC - GALWAY H7493902532300

Patients

Seq Age Sex Outcome Treatment
1 Other