FDA Adverse Event Death Summary report: N

TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM

MDR report key: 788193 · Received November 28, 2006

Report

Report Number
6000093-2006-02450
Event Type
Death
Date Received
November 28, 2006
Date of Event
March 2, 2005
Report Date
October 30, 2006
Manufacturer
BOSTON SCIENTIFIC
Product Code
NIQ
PMA / PMN Number
p030025
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WV, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

H6. THE DELIVERY DEVICE WAS DISPOSED AND THE STENT REMAINED IN THE PT. THEREFORE, NO ANALYSIS COULD BE PERFORMED. THE MFG RECORDS FOR TOP ASSEMBLY BATCH 7142543 HAVE BEEN REVIEWED AND NO ISSUES OR DISCREPANCIES WERE FOUND. THIS RECORDS REVIEW CONFIRMS THAT THE DEVICE MET ALL MATERIAL, ASSEMBLY, AND PERFORMANCE SPECIFICATIONS.

Description of Event or Problem · 1

IT WAS REPORTED THAT POST A CORONARY DRUG ELUTING STENTING TREATMENT PROCEDURE, A DEATH OCCURRED. "SON OF CONSUMER STATES THAT HIS FATHER DIED IN 2005. SON DOES NOT KNOW THE OFFICIAL CAUSE OF DEATH." ADDITIONAL INFO REGARDING THIS EVENT IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TAXUS EXPRESS2 PACLITAXEL-ELUTING CORONARY STENT SYSTEM NIQ STENT, CORONARY, DRUG-ELUTING NIQ BOSTON SCIENTIFIC 2.5X16MM 7142543

Patients

Seq Age Sex Outcome Treatment
1 * Death