FDA Adverse Event Injury Summary report: N

AXIALIF 2L

MDR report key: 1374317 · Received May 4, 2009

Report

Report Number
3004578806-2009-00014
Event Type
Injury
Date Received
May 4, 2009
Date of Event
April 14, 2009
Report Date
April 14, 2009
Manufacturer
TRANS1 INCORPORATED
Product Code
JDN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE MANUFACTURER DOES NOT KNOW WHETHER OR NOT THE USER FACILITY IS REPORTING THIS EVENT. THERE WAS NO EVIDENCE OF OUT OF SPECIFICATION CONDITION THAT COULD HAVE CONTRIBUTED TO THIS EVENT. IN RETROSPECT, DURING TREATMENT OF THE INJURY, IT WAS LEARNED THAT BOWEL WALL WAS VERY THIN AND THAT THE PATIENT HAD A HISTORY OF HEAVY ALCOHOL USAGE. THE CONDITION OF THE BOWEL WAS NOT KNOWN BEFORE THE SURGERY, BUT IT APPEARS VERY LIKELY TO BE A FACTOR IN THIS EVENT.

Description of Event or Problem · 1

BOWEL INJURY TREATED WITH TEMPORARY DIVERTING COLOSTOMY AND GRAM NEGATIVE ANTIBIOTICS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AXIALIF 2L ANTERIOR SPINAL FIXATION JDN TRANS1 INCORPORATED 043620708G

Patients

Seq Age Sex Outcome Treatment
1 57 YR Hospitalization| R