MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION PROMUS ELEMENT PLUS; STENT, CORONARY, DRUG-ELUTING

Model Number 9392

Device Problem Failure to Advance (2524)

Patient Problems Thrombosis (2100); Thrombosis/Thrombus (4440)

Event Date 08/28/2020

Event Type  Injury  

Event Description

It was reported that the patient experienced thrombus formation.The target lesion was located in the left anterior descending artery.A 3.0 x 32mm promus element plus drug-eluting stent was selected for use.During the procedure, the stent could not cross the lesion due to the patient experiencing sudden thrombosis.It is unknown what led to the discovery of the thrombosis but it was removed and the procedure was completed with a different device.No further patient complications were reported and the patient was stable post procedure.

Event Description

It was reported that the patient experienced thrombus formation.The target lesion was located in the left anterior descending artery.A 3.0 x 32mm promus element plus drug-eluting stent was selected for use.During the procedure, the stent could not cross the lesion due to the patient experiencing sudden thrombosis.It is unknown what led to the discovery of the thrombosis but it was removed and the procedure was completed with a different device.No further patient complications were reported and the patient was stable post procedure.

Manufacturer Narrative

Device evaluated by mfr: a promus element plus, mr, ous 3.00x32mm stent delivery system was returned for analysis.A visual examination of the stent found no issues.There was no sign of damage, stretching or lifting of the stent struts.The stent showed no signs of movement and was set between the proximal and distal marker bands.The crimped stent outer diameter was measured and the result was within maximum crimped stent profile measurement.The balloon cones were reviewed, and no issues were noted.The balloon wings were tightly wrapped and evenly folded and were not subjected to positive pressure.A visual and microscopic examination of the bumper tip showed no signs of damage.A visual and tactile examination of the hypotube identified a hypotube kink at 19.6 cm distal from the strain relief.A visual and tactile examination of the outer and mid-shaft section and a visual examination of the inner lumen found no issues along the shaft polymer extrusion.

• Brand Name: PROMUS ELEMENT PLUS
• Type of Device: STENT, CORONARY, DRUG-ELUTING
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; two scimed place; maple grove MN 55311
• MDR Report Key: 10571232
• MDR Text Key: 208090522
• Report Number: 2134265-2020-13183
• Device Sequence Number: 1
• Product Code: NIQ
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,distri
• Type of Report: Initial,Followup
• Report Date: 05/13/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 06/12/2021
• Device Model Number: 9392
• Device Catalogue Number: 9392
• Device Lot Number: 0024003879
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 03/25/2021
• Initial Date Manufacturer Received: 08/29/2020
• Initial Date FDA Received: 09/22/2020
• Supplement Dates Manufacturer Received: 04/21/2021
• Supplement Dates FDA Received: 05/13/2021
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention
• Patient Age: 50 YR
• Patient Weight: 60