BEUDAMED
    FDA Adverse Event Other Summary report: N

    CYPHER

    MDR report key: 502011 · Received December 3, 2003

    Report

    Report Number
    502011
    Event Type
    Other
    Date Received
    December 3, 2003
    Date of Event
    October 1, 2003
    Report Date
    November 1, 2003
    Manufacturer
    CORDIS CORP
    Product Code
    NIQ
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A CYPHER STENT WAS PLACED IN THE PDA [POSTERIOR DESCENDING ARTERY] IN 2003. THE PT WAS BROUGHT BACK TO INTERVENE ON THE MID RCA [RIGHT CORONARY ARTERY]. WHEN THE PICTURES WERE TAKEN, THE CYPHER STENT WAS NOTED TO BE OCCLUDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CYPHER STENT NIQ CORDIS CORP H739CXS182502 A0903580

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Other