FDA Adverse Event Malfunction Summary report: N

CD HORIZON LEGACY SPINAL SYSTEM

MDR report key: 1041216 · Received May 8, 2008

Report

Report Number
1030489-2008-00224
Event Type
Malfunction
Date Received
May 8, 2008
Date of Event
March 25, 2008
Report Date
April 11, 2008
Manufacturer
MEDTRONIC SOFAMOR DANEK
Product Code
KWP
PMA / PMN Number
K052187
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE SETSCREWS AND BONE SCREWS WERE RETURNED TO MEDTRONIC FOR EVAL. BOTH BONE SCREWS SHOW SIGNS OF HEAD SPLAY. FACE OF SETSCREWS SHOW SIGNS THAT PROPER REDUCTION OF ROD MAY NOT HAVE TAKEN PLACE. ONE SETSCREW SHOWS SIGNS OF POSSIBLE CROSSTHREADING. A REVIEW OF THE DEVICE HISTORY RECORDS FOUND NO DOCUMENTATION TO INDICATE A NON-CONFORMANCE TO SPECIFICATION.

Description of Event or Problem · 1

IT WAS REPORTED THE THE SURGEON HAD DIFFICULTY LOCKING THE SETSCREWS INTO THE SCREW HEADS. THE SURGEON CHANGED THE SCREWS AND SETSCREWS AND COMPLETED THE CASE WITH NO FURTHER COMPLICATIONS. NO PT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CD HORIZON LEGACY SPINAL SYSTEM SETSCREW KWP MEDTRONIC SOFAMOR DANEK NA H07L7303

Patients

Seq Age Sex Outcome Treatment
1 UNK