FDA Adverse Event Injury Summary report: N

MOBI-C IMPLANT M"STANDARD" 15X17 H5

MDR report key: 14885339 · Received July 1, 2022

Report

Report Number
3004788213-2022-00050
Event Type
Injury
Date Received
July 1, 2022
Date of Event
June 9, 2022
Report Date
October 6, 2022
Manufacturer
LDR MÉDICAL
Product Code
MJO
UDI-DI
03662663018586
PMA / PMN Number
SEE-H10
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS DEVICE IS NOT CLEARED WITHIN THE US. HOWEVER, IT IS SIMILAR TO MB3575, WHICH IS CLEARED UNDER P110009. WITHOUT A PRODUCT RETURN, NO PRODUCT EVALUATION IS ABLE TO BE CONDUCTED. THE LOT NUMBER IS UNKNOWN; THEREFORE THE DEVICE HISTORY RECORDS ARE UNABLE TO BE REVIEWED. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT. IF ADDITIONAL INFORMATION IS OBTAINED THAT ADDS VALUE TO THE RELEVANT CONTENT OF THIS REPORT AND/OR A CONCLUSION CAN BE DRAWN, A FOLLOW-UP REPORT WILL BE SENT.

Additional Manufacturer Narrative · 0

CORRECTIONS IN D4: LOT NUMBER AND UDI NUMBER, D9, AND H3. ADDITIONAL INFORMATION IN D4: EXPIRATION DATE AND H4. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT. A FOLLOW UP REPORT WILL BE SENT UPON COMPLETION OF THE DEVICE EVALUATION.

Additional Manufacturer Narrative · 0

CORRECTIONS IN H3. ADDITIONAL INFORMATION IN H6: COMPONENT, INVESTIGATION TYPE, FINDINGS, AND CONCLUSIONS. DEVICE EVALUATION: THE DEVICE WAS EVALUATED. THE INVESTIGATION FOUND THAT THERE WAS NO IMPINGEMENT ON THE PLATES BUT THERE IS A "NOTCH" ON THE INSERT, CAUSED DURING THE REMOVAL OF THE DEVICE. THERE WAS NO DAMAGE NOTICED IN THE X-RAYS PROVIDED. ROOT CAUSE: THE ROOT CAUSE WAS UNABLE TO BE DETERMINED. THIS EVENT COULD POSSIBLY BE ATTRIBUTED TO TRAUMA, PATIENT FACTORS OR OTHER UNKNOWN OPERATIONAL FACTORS. DHR REVIEW: PER DHR REVIEW, THE PART WAS LIKELY CONFORMING WHEN IT LEFT ZIMVIE CONTROL. DEVICE USAGE: THIS DEVICE IS USED FOR TREATMENT. IF ADDITIONAL INFORMATION IS OBTAINED THAT ADDS VALUE TO THE RELEVANT CONTENT OF THIS REPORT, A FOLLOW-UP REPORT WILL BE SENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED TO ADDRESS A MOBI-C IMPLANT THAT WAS SEVERELY KYPHOTIC WITH IMPINGEMENT ON THE ANTERIOR SIDE C6/C7 AFTER THE PATIENT FELL POST-OPERATIVELY. DURING THE REVISION, THE PE CORE WAS FOUND TO BE LOCATED CORRECTLY BETWEEN THE PLATES. IT WAS REMOVED AND REPLACED WITH A NEW MOBI-C IMPLANT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED TO ADDRESS A MOBI-C IMPLANT THAT WAS SEVERELY KYPHOTIC WITH IMPINGEMENT ON THE ANTERIOR SIDE C6/C7 AFTER THE PATIENT FELL POST-OPERATIVELY. DURING THE REVISION, THE PE CORE WAS FOUND TO BE LOCATED CORRECTLY BETWEEN THE PLATES. IT WAS REMOVED AND REPLACED WITH A NEW MOBI-C IMPLANT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A REVISION SURGERY WAS PERFORMED TO ADDRESS A MOBI-C IMPLANT THAT WAS SEVERELY KYPHOTIC WITH IMPINGEMENT ON THE ANTERIOR SIDE C6/C7 AFTER THE PATIENT FELL POST-OPERATIVELY. DURING THE REVISION, THE PE CORE WAS FOUND TO BE LOCATED CORRECTLY BETWEEN THE PLATES. IT WAS REMOVED AND REPLACED WITH A NEW MOBI-C IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1548384 MOBI-C IMPLANT M"STANDARD" 15X17 H5 MOBI-C CERVICAL DISC PROSTHESIS MJO LDR MÉDICAL NA L083377 03662663018586

Patients

Seq Age Sex Outcome Treatment
1 Female Required Intervention| H