FDA Adverse Event Death Summary report: N

TAXUS? ELEMENT?

MDR report key: 3355227 · Received September 18, 2013

Report

Report Number
2134265-2013-06329
Event Type
Death
Date Received
September 18, 2013
Date of Event
September 30, 2012
Report Date
August 20, 2013
Manufacturer
BOSTON SCIENTIFIC - MAPLE GROVE
Product Code
NIQ
PMA / PMN Number
P100023
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATED BY MANUFACTURER: 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

SAME CASE AS MDR ID# 2134265-2013-06325; SAME CASE AS MDR ID# 2134265-2013-06326; SAME CASE AS MDR ID# 2134265-2013-06373; SAME CASE AS MDR ID# 2134265-2013-06328. (B)(4). IT WAS REPORTED THAT POST A PERCUTANEOUS CORONARY INTERVENTION PROCEDURE, THE PATIENT EXPERIENCED A MYOCARDIAL INFARCTION AND EXPIRED. (B)(6) 2011 THE PATIENT PRESENTED DUE TO STABLE ANGINA. THE PHYSICIAN TREATED THREE DIFFERENT LESIONS. LESION 1 WAS A LONG LESION LOCATED IN THE PROXIMAL LEFT ANTERIOR DESCENDING (LAD) ARTERY TO DISTAL LAD WITH 75% STENOSIS AND WAS 65 MM LONG WITH A REFERENCE VESSEL DIAMETER OF 2.75 MM. THE PHYSICIAN TREATED THE LESION WITH PRE-DILATATION AND IMPLANTATION OF OVERLAPPING 2.5 X 24 MM, 2.5 X 32 MM , AND 3.0 X 16 MM TAXUS ELEMENT STENTS. FOLLOWING POST-DILATATION, RESIDUAL STENOSIS WAS 0%. LESION 2 WAS LOCATED IN THE 1ST DIAGONAL WITH 75% STENOSIS AND WAS 12 MM LONG WITH A REFERENCE VESSEL DIAMETER OF 2.4 MM. THE PHYSICIAN TREATED THE LESION WITH DIRECT STENT PLACEMENT USING A 2.5 X 16 MM TAXUS ELEMENT STENT WITH 0% RESIDUAL STENOSIS. LESION 3 WAS LOCATED IN THE 2ND OBTUSE MARGINAL WITH 75% STENOSIS AND WAS 15 MM LONG WITH A REFERENCE VESSEL DIAMETER OF 2.8 MM. THE PHYSICIAN TREATED THE LESION WITH DIRECT STENT PLACEMENT OF A 3.0 X 20 MM TAXUS ELEMENT STENT WITH 0% RESIDUAL STENOSIS. POST INDEX PROCEDURE, THE PATIENT HAD ELEVATED TROPONIN VALUES (PEAK TROPONIN= 137 NG/L, UL= 14 NG/L). NO ISCHEMIC SYMPTOMS WERE OBSERVED AND NO ACTION WAS TAKEN TO TREAT THIS EVENT. THE PATIENT WAS DISCHARGED 2 DAYS LATER ON ASPIRIN AND CLOPIDOGREL. (B)(6) 2013, 438 DAYS POST INDEX PROCEDURE THE PATIENT EXPERIENCED AN MYOCARDIAL INFARCTION AND SUBSEQUENTLY EXPIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
469597 TAXUS? ELEMENT? CORONARY DRUG-ELUTING STENT NIQ BOSTON SCIENTIFIC - MAPLE GROVE H7493902520300 14236217

Patients

Seq Age Sex Outcome Treatment
1 55 YR Death