FDA Adverse Event
Injury
Summary report: N
INTRACEPT ACCESS INSTRUMENTS
MDR report key: 14740034
·
Received June 18, 2022
Report
- Report Number
- 3006789852-2022-00004
- Event Type
- Injury
- Date Received
- June 18, 2022
- Date of Event
- December 1, 2021
- Report Date
- January 25, 2022
- Manufacturer
- RELIEVANT MEDSYSTEMS, INC.
- Product Code
- GXI
- UDI-DI
- 00852454006189
- PMA / PMN Number
- K213836
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
PATIENT HAD A L2 COMPRESSION FRACTURE 14 DAYS POST-OP. PATIENT WAS SUBSEQUENTLY TREATED WITH A L2 VERTEBROPLASTY/ABALOPARATIDE. INTERCEPT TREATMENT OCCURRED ON L2-S1, 5 LEVELS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1399162 | INTRACEPT ACCESS INSTRUMENTS | PROBE, RADIOFREQUENCY LESION AND ACCESSORIES | GXI | RELIEVANT MEDSYSTEMS, INC. | FG 0060 | 127325121 | 00852454006189 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 85 YR | Unknown | Disability| R |