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