FDA Adverse Event Death Summary report: N

CYPHER SIROLIMUS-ELUTING CORONARY STENT

MDR report key: 564050 · Received January 5, 2005

Report

Report Number
3003742446-2005-01194
Event Type
Death
Date Received
January 5, 2005
Date of Event
December 1, 2004
Report Date
January 5, 2005
Manufacturer
CORDIS LLC (PR)
Product Code
NIQ
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
DC, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

SAT/DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CYPHER SIROLIMUS-ELUTING CORONARY STENT DRUG-ELUTING STENT NIQ CORDIS LLC (PR) NA X0904800

Patients

Seq Age Sex Outcome Treatment
1 54 YR Death TAXUS STENT