FDA Adverse Event Malfunction Summary report: N

PROMUS ELEMENT? PLUS

MDR report key: 3090327 · Received May 2, 2013

Report

Report Number
2134265-2013-03149
Event Type
Malfunction
Date Received
May 2, 2013
Date of Event
April 4, 2013
Report Date
April 5, 2013
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
NIQ
PMA / PMN Number
P110010
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE LOT NUMBER, DEVICE EXPIRATION DATE, DEVICE MANUFACTURED DATE - UPDATED. (B)(4).

Additional Manufacturer Narrative · 1

DEVICE IS A COMBINATION PRODUCT. (B)(4).

Additional Manufacturer Narrative · 1

DATE OF THIS REPORT ON PREVIOUS REPORT SHOULD HAVE BEEN (B)(4) 2013. DEVICE EVALUATED BY MFR.: A VISUAL AND MICROSCOPIC EXAMINATION FOUND THAT THE STENT WAS DAMAGED. STRUTS ON THE MOST DISTAL ROW WERE BENT OUTWARDS. THE HYPOTUBE WAS SEVERELY KINKED JUST DISTAL TO THE MANIFOLD STRAIN RELIEF. NO ISSUES WERE NOTED WITH THE TIP AND BALLOON OF THE DEVICE THAT COULD HAVE POTENTIALLY CONTRIBUTED TO THE COMPLAINT INCIDENT. THE BALLOON WAS TIGHTLY WRAPPED AND WAS NOT SUBJECTED TO POSITIVE PRESSURE. NO KINKS OR DAMAGE WERE NOTICED ALONG THE REMAINDER OF THE SHAFT OF THE DEVICE. TRACES OF BLOOD WERE VISIBLE IN THE GUIDEWIRE LUMEN INDICATING THE DEVICE WAS USED IN VIVO. SOLIDIFIED CONTRAST MEDIUM WAS VISIBLE IN THE INFLATION LUMEN INDICATING THE DEVICE WAS PREPPED FOR USE. THE MANUFACTURING BATCH RECORD REVIEW CONFIRMED THAT THE DEVICE MET ALL MATERIAL, ASSEMBLY AND PERFORMANCE SPECIFICATIONS. THE MOST PROBABLE ROOT CAUSE IS OPERATIONAL CONTEXT AS DEVICE PERFORMANCE WAS LIMITED DUE TO ANATOMICAL AND/OR PROCEDURAL FACTORS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PERCUTANEOUS CORONARY INTERVENTION, A STENT DAMAGE OCCURRED. VASCULAR ACCESS WAS OBTAINED VIA RADIAL ARTERY. THE 99% STENOSED TARGET LESION WAS LOCATED IN A SEVERELY CALCIFIED AND MODERATELY TORTUOUS OBTUSE MARGINAL BRANCH. INITIALLY, THEY PERFORMED PLAIN OLD BALLOON ANGIOPLASTY WITH A BALLOON CATHETER AFTER SUCCESSFULLY ADVANCING A GUIDE WIRE. A 2.25X28MM PROMUS ELEMENT PLUS STENT DELIVERY SYSTEM WAS ADVANCED BY THE PHYSICIAN BUT FAILED TO CROSS THE TARGET LESION. THE GUIDE WIRE WAS ADVANCED FURTHER AND THEY ATTEMPTED TO RE-ADVANCE THE STENT DELIVERY SYSTEM THROUGH THE TARGET LESION BUT FAILED TO CROSS AGAIN. THE DEVICE WAS REMOVED INTACT BY THE PHYSICIAN. HOWEVER, UPON RETRIEVAL THEY NOTICED THAT THE DISTAL EDGE WAS LIFTED. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED AND THE PATIENTS'S STATUS WAS GOOD.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PERCUTANEOUS CORONARY INTERVENTION, A STENT DAMAGE OCCURRED. VASCULAR ACCESS WAS OBTAINED VIA RADIAL ARTERY. THE 99% STENOSED TARGET LESION WAS LOCATED IN A SEVERELY CALCIFIED AND MODERATELY TORTUOUS OBTUSE MARGINAL BRANCH. INITIALLY, THEY PERFORMED PLAIN OLD BALLOON ANGIOPLASTY WITH A BALLOON CATHETER AFTER SUCCESSFULLY ADVANCING A GUIDE WIRE. A 2.25X28MM PROMUS ELEMENT PLUS STENT DELIVERY SYSTEM WAS ADVANCED BY THE PHYSICIAN BUT FAILED TO CROSS THE TARGET LESION. THE GUIDE WIRE WAS ADVANCED FURTHER AND THEY ATTEMPTED TO RE-ADVANCE THE STENT DELIVERY SYSTEM THROUGH THE TARGET LESION BUT FAILED TO CROSS AGAIN. THE DEVICE WAS REMOVED INTACT BY THE PHYSICIAN. HOWEVER, UPON RETRIEVAL THEY NOTICED THAT THE DISTAL EDGE WAS LIFTED. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED AND THE PATIENTS'S STATUS WAS GOOD.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PERCUTANEOUS CORONARY INTERVENTION, A STENT DAMAGE OCCURRED. VASCULAR ACCESS WAS OBTAINED VIA RADIAL ARTERY. THE 99% STENOSED TARGET LESION WAS LOCATED IN A SEVERELY CALCIFIED AND MODERATELY TORTUOUS OBTUSE MARGINAL BRANCH. INITIALLY, THEY PERFORMED PLAIN OLD BALLOON ANGIOPLASTY WITH A BALLOON CATHETER AFTER SUCCESSFULLY ADVANCING A GUIDE WIRE. A 2.25X28MM PROMUS ELEMENT PLUS STENT DELIVERY SYSTEM WAS ADVANCED BY THE PHYSICIAN BUT FAILED TO CROSS THE TARGET LESION. THE GUIDE WIRE WAS ADVANCED FURTHER AND THEY ATTEMPTED TO RE-ADVANCE THE STENT DELIVERY SYSTEM THROUGH THE TARGET LESION BUT FAILED TO CROSS AGAIN. THE DEVICE WAS REMOVED INTACT BY THE PHYSICIAN. HOWEVER, UPON RETRIEVAL THEY NOTICED THAT THE DISTAL EDGE WAS LIFTED. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED AND THE PATIENTS'S STATUS WAS GOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
191580 PROMUS ELEMENT? PLUS STENT, CORONARY, DRUG-ELUTING NIQ BOSTON SCIENTIFIC - GALWAY H7493918428220 15678348

Patients

Seq Age Sex Outcome Treatment
1 GUIDING CATHETER: LUNCHER7FSL4.0| BALLOON CATHETER: BP2.0 X 15| STENT: PROMUS ELEMENT 2.25 X 28| GUIDEWIRE: RUNTHROUGH SIONBLUE