BEUDAMED
    FDA Adverse Event Other Summary report: N

    ZINGER SUPPORT

    MDR report key: 626196 · Received July 22, 2005

    Report

    Report Number
    626196
    Event Type
    Other
    Date Received
    July 22, 2005
    Date of Event
    March 15, 2005
    Report Date
    July 22, 2005
    Manufacturer
    MEDTRONIC VASCULAR
    Product Code
    DQX
    Report Source
    User Facility report
    Reporter Location
    IL, US

    Narratives

    Description of Event or Problem · 1

    THE PATIENT WAS UNDERGOING RIGHT CORONARY ARTERY STENT DEPLOYMENT WHEN THE WIRE TIP CAME OFF THE MAIN SHAFT. THE WIRE TIP MIGRATED INTO A SIDE BRANCH AND A STENT WAS DEPLOYED OVER THE WIRE TO PREVENT ANY FURTHER WIRE MOVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ZINGER SUPPORT CORONARY GUIDEWIRE DQX MEDTRONIC VASCULAR ZNGRS180HS 0000026617

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR