FDA Adverse Event Injury Summary report: N

CD HORIZON SPINAL SYSTEM

MDR report key: 1082262 · Received July 24, 2008

Report

Report Number
1030489-2008-00363
Event Type
Injury
Date Received
July 24, 2008
Date of Event
June 27, 2008
Report Date
June 30, 2008
Manufacturer
WARSAW ORTHOPAEDIC INC.
Product Code
KWP
PMA / PMN Number
K981676
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EIGHT SETSCREWS WERE RETURNED TO MEDTRONIC FOR EVALUATION AS WELL AS ONE POST-OP LATERAL X-RAY. VISUAL EXAMINATION OF THE RETURNED IMPLANTS FOUND THAT A FEW OF THE SETSCREWS REVEAL MARKINGS THAT MAY INDICATE THE ROD MAY NOT HAVE BEEN FULLY SEATED. X-RAY EXAMINATION CONFIRMED THE SETSCREWS BACKED OUT AT THE MOST CEPHALAD LEVEL.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A POST-OP FOLLOW-UP VISIT, X-RAYS TAKEN IN 2008 REVEALED 2 OF THE 8 IMPLANTED SETSCREWS HAD BACKED OUT OF THE SCREWS. THE PT HAS NO SYMPTOMS. THE PT UNDERWENT A REVISION SURGERY TO REMOVE THE RODS AND SETSCREWS. NO PT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CD HORIZON SPINAL SYSTEM SETSCREW KWP WARSAW ORTHOPAEDIC INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention