FDA Adverse Event Malfunction Summary report: N

PROMUS ELEMENT ?

MDR report key: 3822500 · Received May 21, 2014

Report

Report Number
2134265-2014-02726
Event Type
Malfunction
Date Received
May 21, 2014
Date of Event
April 23, 2014
Report Date
April 23, 2014
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
NIQ
PMA / PMN Number
SIMILAR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TW
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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

Additional Manufacturer Narrative · 1

DEVICE EVALUATED BY MFR: BASED ON THE POTENTIAL ROOT CAUSES IDENTIFIED AND THE COMPLAINT REPORT, THE FOLLOWING ATTRIBUTES WERE EXAMINED: STENT PROFILE: A VISUAL EXAMINATION OF THE STENT FOUND THAT THE CRIMPED STENT ON THE DEVICE WAS DAMAGED. IT WAS NOTED THAT STENT STRUTS ON THE DISTAL PORTION WERE LIFTED, BUNCHED, STRETCHED AND DEFORMED. THE PROXIMAL END OF THE CRIMPED STENT APPEARED UNDAMAGED. TIP PROFILE: THE BUMPER TIP OF THE DEVICE SHOWED SIGNS OF DAMAGE. BALLOON PROFILE: THE BALLOON CONES PROFILES WERE REVIEWED AND NO ISSUES WERE NOTED WITH THE OVERALL BALLOON PROFILE. THE BALLOON WINGS WERE TIGHTLY WRAPPED AND EVENLY FOLDED AND WERE NOT SUBJECTED TO POSITIVE PRESSURE. HYPOTUBE PROFILE: A VISUAL AND TACTILE EXAMINATION FOUND MULTIPLE KINKS ALONG THE LENGTH OF THE HYPOTUBE. SHAFT POLYMER EXTRUSION PROFILE: A VISUAL AND TACTILE EXAMINATION FOUND NO ISSUES WITH THE PROFILE. 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 PROCEDURAL FACTORS. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT STENT DAMAGE OCCURRED. THE 100MM X 2.5MM - 4.0MM, ECCENTRIC, DE NOVO, 100% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND MODERATELY CALCIFIED PROXIMAL MID LEFT ANTERIOR DESCENDING ARTERY WITH A SIGNIFICANT BEND OF <=45 DEGREES. FOLLOWING THE ADVANCEMENT OF A NON BSC GUIDE CATHETER AND A NON BSC GUIDEWIRE, THE LESION WAS PREDILATED WITH A 2.5/15 APEX BALLOON CATHETER. SUBSEQUENTLY, A 3.50X24MM PROMUS ELEMENT ¿ DRUG ELUTING STENT WAS ADVANCED TO TREAT THE LESION. HOWEVER, IN AN ATTEMPT OF REPOSITIONING THE DEVICE, SIGNIFICANT RESISTANCE WAS MET. EVENTUALLY, THE DEVICE WAS REMOVED BUT THE DISTAL SEGMENT OF THE STENT WAS NOTED TO HAVE DIVERGED. STENT DISTAL WAS TWISTED AND SEEMED LIKE THERE WAS A SPLIT. FOLLOWING COMPLETE RETRIEVAL OF THE STENT, THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED AND PATIENT'S STATUS WAS STABLE.

Description of Event or Problem · 1

IT WAS REPORTED THAT STENT DAMAGE OCCURRED. THE 100MM X 2.5MM - 4.0MM, ECCENTRIC, DE NOVO, 100% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND MODERATELY CALCIFIED PROXIMAL MID LEFT ANTERIOR DESCENDING ARTERY WITH A SIGNIFICANT BEND OF <=45 DEGREES. FOLLOWING THE ADVANCEMENT OF A NON BSC GUIDE CATHETER AND A NON BSC GUIDEWIRE, THE LESION WAS PREDILATED WITH A 2.5/15 APEX BALLOON CATHETER. SUBSEQUENTLY, A 3.50X24MM PROMUS ELEMENT ¿ DRUG ELUTING STENT WAS ADVANCED TO TREAT THE LESION. HOWEVER, IN AN ATTEMPT OF REPOSITIONING THE DEVICE, SIGNIFICANT RESISTANCE WAS MET. EVENTUALLY, THE DEVICE WAS REMOVED BUT THE DISTAL SEGMENT OF THE STENT WAS NOTED TO HAVE DIVERGED. STENT DISTAL WAS TWISTED AND SEEMED LIKE THERE WAS A SPLIT. FOLLOWING COMPLETE RETRIEVAL OF THE STENT, THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO PATIENT COMPLICATIONS WERE REPORTED AND PATIENT'S STATUS WAS STABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
303739 PROMUS ELEMENT ? STENT, CORONARY, DRUG-ELUTING NIQ BOSTON SCIENTIFIC - GALWAY H7493911324350 16628907

Patients

Seq Age Sex Outcome Treatment
1 48 YR BALLOON CATHETER: APEX 2.5/15| GUIDE CATHETER: MACH 1,6FR VL3.5| GUIDE WIRE: ASAHI, MIRACLE 12