BEUDAMED
    FDA Adverse Event Death Summary report: N

    J & J CYPHER STENT

    MDR report key: 792865 · Received December 10, 2006

    Report

    Report Number
    MW1041316
    Event Type
    Death
    Date Received
    December 10, 2006
    Date of Event
    September 4, 2006
    Report Date
    December 10, 2006
    Manufacturer
    J & J
    Product Code
    NIQ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CT, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    SUDDEN DEATH, CORONARY STENT CORONARY INFARC: COLLAPSED ON GOLF COURSE, TURNING BLUE. IMMEDIATE EFFORTS AT CPR FOLLOWED, FOLLOWED BY - 17 MINUTES LATER - EMT REMOVAL TO HOSP. ESSENTIALLY DOA. HAD SINGLE J&J CYPHER STENT -CXS08250- PLACED IN HIS LEFT ANTERIOR DESCENDING CORONARY ARTERY IN 2005 FOR ACUTE ANTERIOR MI.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 J & J CYPHER STENT * NIQ J & J * *

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Death