ABSORB UNK ABSORB

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-16 for ABSORB UNK ABSORB manufactured by Abbott Vascular.

Event Text Entries

[183610454] Patient age estimated. Date of death estimated. Date of event estimated. The unique device identifier (udi) is unknown because the part and lot. Numbers were not provided. Implant date estimated. The scaffold remains in patient. The device will not be returned for evaluation. Investigation is not yet complete. A follow-up report will be submitted with all additional relevant information. Na
Patient Sequence No: 1, Text Type: N, H10


[183610455] It was reported that the patient underwent a coronary procedure, with implantation of an absorb bioresorbable vascular scaffold. The patient had previously underwent a coronary stenting procedure, with implantation of an unspecified bare metal stent in the right coronary artery (rca) artery, leaving untreated diseased lesion proximal to the bare metal stent. The patient underwent a second coronary procedure, on an unspecified date, and a long unspecified xience stent was implanted, covering the bare metal stent and the proximal diseased lesion. Two absorb scaffolds were implanted in the proximal and mid left anterior descending (lad) artery, in overlapping fashion. Imaging was performed and noted good results. The patient was placed on dual anti-platelet therapy (dapt) post procedure and remained on dapt for three years; however, the dapt had recently been discontinued. It was reported that the patient was found dead at home. The patient had complained of not feeling well and it was assumed that the patient experienced angina and possibly in-scaffold thrombosis. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-02504
MDR Report Key9837927
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-16
Date of Report2020-03-16
Date of Event2020-02-01
Date Mfgr Received2020-02-22
Date Added to Maude2020-03-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. LINDSEY BELL
Manufacturer Street26531 YNEZ RD.
Manufacturer CityTEMECULA CA 925914628
Manufacturer CountryUS
Manufacturer Postal925914628
Manufacturer Phone9519143996
Manufacturer G1ABBOTT VASCULAR, REG # 2024168
Manufacturer Street26531 YNEZ ROAD
Manufacturer CityTEMECULA CA 925914628
Manufacturer CountryUS
Manufacturer Postal Code925914628
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameABSORB
Generic NameBIORESORBABLE SCAFFOLD
Product CodePNY
Date Received2020-03-16
Catalog NumberUNK ABSORB
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerABBOTT VASCULAR
Manufacturer Address26531 YNEZ RD. TEMECULA CA 925914628 US 925914628


Patients

Patient NumberTreatmentOutcomeDate
101. Death 2020-03-16

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