FDA Adverse Event Death Summary report: N

PROTEGE

MDR report key: 400059 · Received June 17, 2002

Report

Report Number
2134479-2002-00002
Event Type
Death
Date Received
June 17, 2002
Date of Event
May 21, 2002
Report Date
June 10, 2002
Manufacturer
SULZER INTRATHERAPEUTICS INC.
Product Code
FGE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE PHYSICIAN REPORTS THAT WHEN HE ATTEMPTED TO STENT A SUBCLAVICAL STENOSIS FROM THE ARM, THE STENT JUMPED FORWARD PARTIALLY INTO THE THORACIC AORTA. HE SAID THAT HE DEPLOYED A SMART STENT TO TACK THE PROTEGE DOWN BECAUSE HE WAS WORRIED THAT IT MIGHT SLIP FURTHER INTO THE AORTA. IT APPEARED THAT THE PT HAD DONE WELL DURING AND IMMEDIATELY AFTER THE PROCEDURE, BUT EXPIRED WITHIN THE NEXT DAY OR TWO. THE PHYSICIAN HAS NO KNOWLEDGE AT THIS TIME, THAT PT'S DEATH WAS RELATED TO THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROTEGE PERIPHERAL STENT FGE SULZER INTRATHERAPEUTICS INC. SE7-8-40-80 MF2414

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Death SMART STENT (2002 TO 2002).