MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-03-13 for ELUVIA DRUG-ELUTING VASCULAR STENT SYSTEM 24653 manufactured by Boston Scientific Corporation.
[183373758]
Device is combination product. Patient identifier: (b)(6).
Patient Sequence No: 1, Text Type: N, H10
[183373759]
(b)(6) study. It was reported that in stent re-occlusion occurred. The subject underwent treatment with two study devices on (b)(6) 2019 as part of the (b)(6) trial. The target lesion was located in right distal superficial femoral artery (sfa) with 100% stenosis. The lesion was 80 mm long with a proximal and distal reference vessel diameter of 6 mm and was classified as a tasc ii b lesion. The target lesion was treated with pre-dilatation and placement of the 6 mm x 60 mm x 130cm and 6 mm x 40 mm study stents. Following post dilation, residual stenosis was 0%. On (b)(6) 2019, the subject was discharged with an antiplatelet therapy. On (b)(6) 2020, the subject presented for the 6-month follow-up visit. The subject was noted to have re-occlusion in the 6 mm x 60 mm x 130cm stent in the target lesion. No action was taken to treat the event. At the time of reporting, the event was ongoing.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2134265-2020-03127 |
| MDR Report Key | 9829287 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-03-13 |
| Date of Report | 2020-03-13 |
| Date of Event | 2020-02-20 |
| Date Mfgr Received | 2020-02-21 |
| Device Manufacturer Date | 2019-01-07 |
| Date Added to Maude | 2020-03-13 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | JAY JOHNSON |
| Manufacturer Street | TWO SCIMED PLACE |
| Manufacturer City | MAPLE GROVE MN 55311 |
| Manufacturer Country | US |
| Manufacturer Postal | 55311 |
| Manufacturer Phone | 7634942574 |
| Manufacturer G1 | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Street | BALLYBRIT BUSINESS PARK |
| Manufacturer City | GALWAY |
| Manufacturer Country | EI |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ELUVIA DRUG-ELUTING VASCULAR STENT SYSTEM |
| Generic Name | STENT, SUPERFICIAL FEMORAL ARTERY, DRUG-ELUTING |
| Product Code | NIU |
| Date Received | 2020-03-13 |
| Model Number | 24653 |
| Catalog Number | 24653 |
| Lot Number | 0023259439 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Address | TWO SCIMED PLACE MAPLE GROVE MN 55311 US 55311 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-03-13 |