FDA Adverse Event
Injury
Summary report: N
ENDEAVOR SPRINT RX
MDR report key: 3922133
·
Received July 9, 2014
Report
- Report Number
- 9612164-2014-00755
- Event Type
- Injury
- Date Received
- July 9, 2014
- Date of Event
- September 8, 2010
- Report Date
- June 18, 2014
- Manufacturer
- MEDTRONIC IRELAND
- Product Code
- NIQ
- PMA / PMN Number
- P060033
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- BR
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
EVALUATION, RESULTS, CONCLUSIONS: INHERENT RISK OF PROCEDURE ¿ (DISSECTION). (B)(4).
Description of Event or Problem · 1
ONE ENDEAVOR SPRINT DRUG ELUTING STENT WAS IMPLANTED IN THE RCA DURING THE INDEX PROCEDURE. 12 DAYS POST INDEX PROCEDURE, THE PATIENT UNDERWENT A STAGED PROCEDURE 5 STENTS WERE USED - ONE ENDEAVOR SPRINT DRUG ELUTING STENT WAS IMPLANTED IN THE CX, TWO ENDEAVOR SPRINT DRUG ELUTING STENTS WERE IMPLANTED IN THE LAD. A DISSECTION OCCURRED DURING LAD STENT IMPLANTATION. A FURTHER TWO ENDEAVOR SPRINT DRUG ELUTING STENTS WERE IMPLANTED IN THE 1ST DIAGONAL. STENT RECOIL WAS REPORTED TO HAVE OCCURRED DURING 1ST DIAGONAL STENT IMPLANTATION AND AN ADDITIONAL STENT WAS PLACED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 401200 | ENDEAVOR SPRINT RX | STENT, CORONARY, DRUG-ELUTING | NIQ | MEDTRONIC IRELAND | 0000876282 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 00057 YR | Required Intervention |