FDA Adverse Event Injury Summary report: N

PROMUS ELEMENT PLUS EVEROLIMUS-ELUTING PLATINUM CHROMIUM CORONARY STENT SYSTEM

MDR report key: 4092495 · Received September 16, 2014

Report

Report Number
2134265-2014-05619
Event Type
Injury
Date Received
September 16, 2014
Report Date
August 26, 2014
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
NIQ
PMA / PMN Number
P110010
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE IS A COMBINATION PRODUCT. DEVICE EVALUATED BY MFR: THE DEVICE HAS NOT BEEN RECEIVED FOR ANALYSIS. UPON RECEIPT AND COMPLETION OF THE FAILURE ANALYSIS OF THE COMPLAINT DEVICE, IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Additional Manufacturer Narrative · 1

DEVICE EVALUATED BY MFR: THE STENT HAD DETACHED FROM THE BALLOON. ONLY THE STENT WAS RETURNED FOR ANALYSIS. THE ENTIRE STENT WAS DAMAGED WITH THE STENT STRUTS STRETCHED AND DISTORTED. THE STENT DELIVERY CATHETER WAS NOT RETURNED FOR ANALYSIS. THE BATCH NUMBER IS UNKNOWN AND THE MANUFACTURING RECORDS FOR THE COMPLAINT DEVICE COULD NOT BE REVIEWED. THE MOST PROBABLE CAUSE OF THE REPORTED DIFFICULTIES MAY BE DUE INTERACTION WITH ANOTHER DEVICE. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT STENT THROMBOSIS OCCURRED AND THE STENT WAS EXPLANTED. THE TARGET LESION WAS LOCATED IN THE LEFT ANTERIOR DESCENDING ARTERY. AN UNSPECIFIED SIZE PROMUS ELEMENT PLUS EVEROLIMUS-ELUTING PLATINUM CHROMIUM CORONARY STENT SYSTEM WAS IMPLANTED. SUBSEQUENTLY, A FEW WEEKS AFTER STENT IMPLANTATION, THE PATIENT HAD STENT THROMBOSIS. TO TREAT STENT THROMBOSIS, A NON BSC GUIDEWIRE WAS PLACED IN THE TARGET VESSEL FOLLOWED WITH THE INSERTION OF A NON BSC BALLOON CATHETER AND EVENTUALLY WITH THE INSERTION OF A THROMBECTOMY DEVICE. WHEN THE PHYSICIAN PULLED THE THROMBECTOMY DEVICE, THE IMPLANTED STENT WAS ATTACHED TO THE END OF THE THROMBECTOMY CATHETER. THE PHYSICIAN FIGURED THAT WHEN THE WIRE WAS PLACED, IT WENT THROUGH THE STENT STRUT AND WHEN THE BALLOON CATHETER WAS USED, IT PULLED THE STENT AWAY FROM THE ARTERY. FINALLY, WHEN THE THROMBECTOMY DEVICE WAS USED, THE END OF THE CATHETER "WEDGED" IN THE STENT STRUT AND WHEN IT WAS PULLED, THE STENT FOLLOWED. ALL THE DEVICES WERE REMOVED COMPLETELY AND THE PROCEDURE WAS COMPLETED. NO PATIENT COMPLICATIONS WERE REPORTED AND THE PATIENT'S STATUS WAS FINE.

Description of Event or Problem · 1

IT WAS REPORTED THAT STENT THROMBOSIS OCCURRED AND THE STENT WAS EXPLANTED. THE TARGET LESION WAS LOCATED IN THE LEFT ANTERIOR DESCENDING ARTERY. AN UNSPECIFIED SIZE PROMUS ELEMENT PLUS EVEROLIMUS-ELUTING PLATINUM CHROMIUM CORONARY STENT SYSTEM WAS IMPLANTED. SUBSEQUENTLY, A FEW WEEKS AFTER STENT IMPLANTATION, THE PATIENT HAD STENT THROMBOSIS. TO TREAT STENT THROMBOSIS, A NON BSC GUIDEWIRE WAS PLACED IN THE TARGET VESSEL FOLLOWED WITH THE INSERTION OF A NON BSC BALLOON CATHETER AND EVENTUALLY WITH THE INSERTION OF A THROMBECTOMY DEVICE. WHEN THE PHYSICIAN PULLED THE THROMBECTOMY DEVICE, THE IMPLANTED STENT WAS ATTACHED TO THE END OF THE THROMBECTOMY CATHETER. THE PHYSICIAN FIGURED THAT WHEN THE WIRE WAS PLACED, IT WENT THROUGH THE STENT STRUT AND WHEN THE BALLOON CATHETER WAS USED, IT PULLED THE STENT AWAY FROM THE ARTERY. FINALLY, WHEN THE THROMBECTOMY DEVICE WAS USED, THE END OF THE CATHETER "WEDGED" IN THE STENT STRUT AND WHEN IT WAS PULLED, THE STENT FOLLOWED. ALL THE DEVICES WERE REMOVED COMPLETELY AND THE PROCEDURE WAS COMPLETED. NO PATIENT COMPLICATIONS WERE REPORTED AND THE PATIENT'S STATUS WAS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
573465 PROMUS ELEMENT PLUS EVEROLIMUS-ELUTING PLATINUM CHROMIUM CORONARY STENT SYSTEM STENT, CORONARY, DRUG-ELUTING NIQ BOSTON SCIENTIFIC - GALWAY UNK717

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention