MAUDE Adverse Event Report: ABBOTT VASCULAR XACT CAROTID STENT SYSTEM; SELF EXPANDING PERIPHERAL STENT SYSTEM

Catalog Number UNK XACT

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problems Stroke/CVA (1770); Myocardial Infarction (1969); Transient Ischemic Attack (2109); Obstruction/Occlusion (2422); Restenosis (4576)

Event Date 01/01/2014

Event Type  Death  

Event Description

It was reported through the post market clinical follow-up (pmcf) report, that the xact stent may be related to the adverse patient effects of death, myocardial infarction, access site complications, transient ischemic attack, stroke, re-stenosis, occlusion, revascularization and re-hospitalization.Details are listed in the attached pmcf, titled post market clinical follow-up evaluation report abbott carotid stent and embolic protection systems.Please see the attached pmcf evaluation report for specific information.

Manufacturer Narrative

Age - average date of death - estimated date of event ¿ estimated the unique device identifier (udi) is unknown because the part number and lot number were not provided.Date of implant ¿ estimated.The device was not returned for evaluation.A review of the lot history record could not be conducted because the part and lot number was not provided.The reported patient effect of death is listed in the xact carotid stent system instructions for use (ifu) as an adverse event potentially associated with carotid stents and embolic protection systems: a conclusive cause for the reported death and the relationship to the product, if any, cannot be determined.There is no indication of a product quality issue with respect to manufacture, design or labeling.The other patient effects and the other adverse events reported in the pmcf are filed under separate medwatch report numbers.Attachment: title ¿post market clinical follow-up evaluation report abbott carotid stent and embolic protection systems.''.

• Brand Name: XACT CAROTID STENT SYSTEM
• Type of Device: SELF EXPANDING PERIPHERAL STENT SYSTEM
• Manufacturer (Section D): ABBOTT VASCULAR; 26531 ynez rd.; temecula CA 92591 4628
• Manufacturer (Section G): ABBOTT VASCULAR, REG # 2024168; 26531 ynez road; temecula CA 92591 4628
• Manufacturer Contact: lindsey bell ; 26531 ynez rd.; temecula, CA 92591-4628 ; 9519143996
• MDR Report Key: 15643477
• MDR Text Key: 302159886
• Report Number: 2024168-2022-10879
• Device Sequence Number: 1
• Product Code: NIM
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: P040038
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 10/20/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 10/20/2022
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Device Catalogue Number: UNK XACT
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 09/29/2022
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Death
• Patient Age: 70 YR
• Patient Sex: Male