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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION SYNERGY XD; CORONARY DRUG-ELUTING STENT

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BOSTON SCIENTIFIC CORPORATION SYNERGY XD; CORONARY DRUG-ELUTING STENT Back to Search Results
Lot Number 0030355448
Device Problems Break (1069); Premature Activation (1484); Difficult to Remove (1528)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 09/21/2023
Event Type  Injury  
Event Description
It was reported that premature deployment and difficulty in removal occurred, requiring additional intervention.The 80% stenosed target lesion was located in the mildly tortuous and severely calcified right coronary artery (rca).Atherectomy and cutting balloons were used successfully without any complications.A 4.00 x 48mm synergy xd drug-eluting stent was advanced for treatment.However, upon delivery, the operator bent the proximal end of the delivery hypotube while attempting to complete crossing the stent.The operator removed the device because of the inability to inflate the delivery system.Upon removal, air was sucked into the balloon because of the change in pressure, which in turn, partially inflated the device, adding to the inability to remove it.It was noted the proximal end of the delivery system broke at the bent area outside the guide catheter, leaving the stent and balloon inside of the stent, partially stuck in the ostium of the rca and in the aorta.All systems and wires were successfully removed via snare through the arteriotomy access site.The procedure was completed with a 2 4.0mm synergy xd and the patient was kept overnight for evaluation and was discharged the next day without any complications.
 
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Brand Name
SYNERGY XD
Type of Device
CORONARY DRUG-ELUTING STENT
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
ballybrit business park
galway
EI  
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key17980754
MDR Text Key326240814
Report Number2124215-2023-58180
Device Sequence Number1
Product Code NIQ
UDI-Device Identifier08714729985242
UDI-Public08714729985242
Combination Product (y/n)Y
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 10/20/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/20/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Lot Number0030355448
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received09/28/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/10/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Hospitalization; Required Intervention;
Patient SexMale
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