FDA Adverse Event Injury Summary report: N

TAXUS LIBERTE PACLITAXEL-ELUTING CORONARY STENT SYSTEM

MDR report key: 3230374 · Received July 16, 2013

Report

Report Number
2134265-2013-04860
Event Type
Injury
Date Received
July 16, 2013
Report Date
June 18, 2013
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
NIQ
PMA / PMN Number
P060008
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

AGE AT TIME OF EVENT: 18 YEARS OR OLDER. EVENT DATE: 2007. IF IMPLANTED, GIVE DATE: 2007. DEVICE IS COMBINATION PRODUCT. DEVICE EVALUATED BY MANUFACTURER: 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 RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT FOLLOWING A CORONARY STENTING TREATMENT PROCEDURE, IN-STENT RESTENOSIS OCCURRED. A TAXUS LIBERTE PACLITAXEL-ELUTING CORONARY STENT SYSTEM WAS ADVANCED AND THE STENT WAS DEPLOYED IN THE TARGET LESION. FOLLOWING STENT DEPLOYMENT THE STENT WAS "BLOCKED" AND WAS TREATED USING A NON-BSC STENT. NO FURTHER PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
327856 TAXUS LIBERTE PACLITAXEL-ELUTING CORONARY STENT SYSTEM CORONARY DRUG-ELUTING STENT NIQ BOSTON SCIENTIFIC - GALWAY UNK433

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention