FDA Adverse Event Death Summary report: N

CYPHER SIROLIMUS-ELUTING CORONARY STENT

MDR report key: 818898 · Received February 12, 2007

Report

Report Number
9616099-2007-00294
Event Type
Death
Date Received
February 12, 2007
Date of Event
July 7, 2006
Report Date
January 19, 2007
Manufacturer
CORDIS DE MEXICO
Product Code
NIQ
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS PT PRESENTED FOR ELECTIVE PERCUTANEOUS CORONARY INTERVENTION (PCI) OF A DE NOVO LESION, IN THE LEFT MAIN TRUCK (LMT), TO THE PROXIMAL LEFT ANTERIOR DESCENDING ARTERY (LAD) OF 44MM IN LENGTH, IN A 3.04MM VESSEL DIAMETER AT A BIFURCATION. THE (TYPE C) ECCENTRIC LESION WAS ALSO CALCIFIED. PRE-PROCEDURE MEDICATIONS INCLUDED ASPIRIN 1001MG/DAY AND TICLOPIDINE HYDROCHLORIDE 200MG/DAY. INTRA-PROCEDURE MEDICATIONS INCLUDED HEPARIN 8000 UNITS. THE LESION WAS PRE-DILATED WITH A 3.0X20MM BALLOON AT 20 ATMOSPHERES (ATM), BEFORE DEPLOYING A 3.0X33MM CYPHER STENT AT 18 ATM. THEN A 3.0X28MM CYPHER STENT WAS DEPLOYED AT 22 ATM, OVERLAPPING THE PREVIOUS STENT. POST-DILATION WAS CONDUCTED WITH A 3.0X20MM BALLOON AT 15 ATM. IVUS WAS NOT CONDUCTED. RESIDUAL DIAMETER STENOSIS MEASUERD 24%. TIMI III FLOWS WERE RECORDED PRE AND POST-PROCEDURE. ACT WAS NOT MONITORED. PCI WAS PERFORMED NEXT ON A DE NOVO LESION, IN THE HIGH LATERAL BRANCH THAT WAS 12MM IN LENGTH, IN A 2.23MM VESSEL DIAMETER AT A BIFURCATION. THE (B2) LESION WAS ALSO CALCIFIED. THE LESION WAS PRE-DILATED WITH A 2.25X14MM BALLOON 8 ATM BEFORE DEPLOYING A 2.5X18MM CYPHER STENT AT 18 ATM. THE BIFURCATED PORTION OF THE LMT TO THE PROXIMAL LAD WAS TREATED BY T-STENTING. POST-DILATATION WAS CONDUCTED WITH A 2.25 X 14MM BALLOON BY KISSING BALLOON TECHNIQUE WITH THE POST-DILATION BALLOON USED FOR THE LMT AND THE PROXIMAL LAD. THE RESIDUAL DIAMETER STENOSIS MEASURED 0%. TIMI III FLOWS WERE RECORDED PRE AND POST-PROCEDURE. ACT WAS NOT MEASURED. POST-PROCEDURE MEDICATIONS INCLUDED ASPIRIN 1001MG/DAY AND TICLOPIDINE HYDROCHLORIDE 200MG/DAY. SIX MONTHS LATER, RESTENOSIS WAS CONFIRMED IN ALL OF THE STENTS. POBA WAS CONDUCTED WITH A 2.5X15MM BALLOON AT 15 ATM. THE RESIDUAL DIAMETER STENOSIS MEASURED 25%. APPROXIMATELY SIX TO SEVEN WEEKS LATER, THE PT HAD BEEN HOSPITALIZED FOR A LONG TIME DUE TO A BURN. HE DEVELOPED AN ACUTE MYOCARDIAL INFARCTION AND VENTRICULAR TACHYCARDIA. HE WENT INTO CARDIOPULMONARY ARREST. ANGIOGRAPHY WAS CONDUCTED AND THROMBUS WAS FOUND IN ALL OF THE PREVIOUSLY IMPLANTED CYPHER STENTS. POBA WAS DONE TO TREAT THE THROMBUS. HOWEVER, THE PT EXPIRED THE FOLLOWING DAY DUE TO HEART FAILURE. A POSTMORTEM WAS NOT PERFORMED. THE PHYSICIAN COMMENTED, THAT THE CAUSE OF THE THROMBOTIC EVENT WAS BECAUSE THE PT WAS A DIALYSIS PT. PLEASE NOTE THAT THIS DEVICE IS NOT DISTRIBUTED IN THE UNITED STATES. HOWEVER, IT IS SIMILAR TO THE US DISTRIBUTED CYPHER SIROLIMUS DRUG ELUTING STENT. IT IS ALSO NOT AVAILABLE FOR TESTING AND EVAL. ADD'L INFO RECEIVED WILL BE SUBMITTED WITHIN 30 DAYS UPON RECEIPT. THIS IS ONE OF THREE PRODUCTS USED IN THE SAME PT THAT WERE SUBMITTED UNDER THE FOLLOWING MFG NUMBERS 9616099-2007-00294, 9616099-2007-00295 AND 9616099-2007-00296.

Description of Event or Problem · 1

SIX MONTHS AFTER PERCUTANEOUS CORONARY INTERVENTION (PCI), RESTENOSIS WAS CONFIRMED IN ALL OF THE PREVIOUSLY TREATED LESIONS. THE PT WAS TREATED, BUT SIX MONTHS LATER DEVELOPED ADD'L ADVERSE EVENTS AND SUBSEQUENTLY DIED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CYPHER SIROLIMUS-ELUTING CORONARY STENT DRUG-ELUTING STENT (NIQ) NIQ CORDIS DE MEXICO NA I0805143

Patients

Seq Age Sex Outcome Treatment
1 62 YR Death| H| R