FDA Adverse Event Malfunction Summary report: N

CRESCENT VERTEBRAL BODY SPACER

MDR report key: 1021054 · Received March 28, 2008

Report

Report Number
1030489-2008-00165
Event Type
Malfunction
Date Received
March 28, 2008
Date of Event
February 26, 2008
Report Date
February 27, 2008
Manufacturer
SOFAMOR DANEK DEGGENDORF GMBH
Product Code
MQP
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE HAS RETURNED TO MEDTRONIC FOR EVAL. EVAL HAS NOT BEEN COMPLETED BUT IS CURRENTLY IN PROGRESS. DEVICE HISTORY RECORDS HAVE BEEN REVIEWED WHICH FOUND NO DOCUMENTATION TO INDICATE A NON-CONFORMANCE TO SPECIFICATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT AFTER FILLING THE IMPLANT WITH BONE, THE SURGEON ATTEMPTED TO IMPLANT THE SPACER WITH THE INSERTER. AFTER A FEW HAMMER HITS THE SPACER BROKE INTO FOUR PIECES WITH ONE PIECE STILL ATTACHED TO THE INSERTER. NO PT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CRESCENT VERTEBRAL BODY SPACER VERTEBRAL BODY SPACER MQP SOFAMOR DANEK DEGGENDORF GMBH NA ND73

Patients

Seq Age Sex Outcome Treatment
1 UNK