FDA Adverse Event Malfunction Summary report: N

MAGEC SPINAL BRACING AND DISTRACTION SYSTEM

MDR report key: 14104349 · Received April 13, 2022

Report

Report Number
3006179046-2022-00167
Event Type
Malfunction
Date Received
April 13, 2022
Report Date
June 27, 2022
Manufacturer
NUVASIVE SPECIALIZED ORTHOPEDICS, INC.
Product Code
PGN
UDI-DI
00812258026349
PMA / PMN Number
K201543
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION. THE ROOT CAUSE IS UNABLE TO BE DETERMINED AT THIS TIME. IF ANY ADDITIONAL INFORMATION IS PROVIDED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

THE REPORTER PROVIDED THE MODEL AND LOT NUMBER OF TWO MAGEC RODS, BUT IT IS UNKNOWN WHICH OF THE TWO HAS THE REPORTED FAILURE TO DISTRACT. THE TWO RODS WERE REPORTED AS FOLLOWS: MS1-4570R LOT NUMBER A171016-03. MS1-4570S LOT NUMBER 0101446.

Additional Manufacturer Narrative · 0

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

Description of Event or Problem · 0

INFORMATION WAS RECEIVED THAT THE ROD WOULD NOT DISTRACT. NO PATIENT ADVERSE EVENT WAS REPORTED.

Description of Event or Problem · 0

ADDITIONAL INFORMATION WAS RECEIVED.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
653284 MAGEC SPINAL BRACING AND DISTRACTION SYSTEM GROWING ROD SYSTEM - MAGNETIC ACTUATION PGN NUVASIVE SPECIALIZED ORTHOPEDICS, INC. MS1-4570R A171016-03-1AM 00812258026349

Patients

Seq Age Sex Outcome Treatment
1 Prefer Not To Disclose