FDA Adverse Event Injury Summary report: N

TSRH SPINAL SYSTEM

MDR report key: 1636510 · Received March 19, 2010

Report

Report Number
1030489-2010-00323
Event Type
Injury
Date Received
March 19, 2010
Date of Event
March 29, 2001
Report Date
February 19, 2010
Manufacturer
WARSAW ORTHOPAEDIC INC.
Product Code
KWQ
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B) (4) - PSEUDARTHROSIS. LITERATURE ARTICLE CITATION: RICHARDS ET AL. DELAYED INFECTIONS AFTER POSTERIOR TSRH SPINAL INSTRUMENTATION FOR IDIOPATHIC SCOLIOSIS. SPINE 2001; 26:18:1990-1996. A REVIEW OF THE DEVICE HISTORY RECORDS FOR THIS DEVICE WAS NOT POSSIBLE WITHOUT ADDITIONAL DEVICE INFORMATION. NEITHER THE DEVICE NOR FILMS OF APPLICABLE IMAGING STUDIES WERE RETURNED TO THE MANUFACTURER FOR EVALUATION. THEREFORE, WE ARE UNABLE TO DETERMINE THE DEFINITIVE CAUSE OF THE REPORTED EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT UNDERWENT A 12-LEVEL POSTERIOR SPINAL INSTRUMENTATION FOR IDIOPATHIC SCOLIOSIS USING HOOK AND CROSSLINK INSTRUMENTATION. FIFTEEN MOTHS POST-OP, THE PT WAS DIAGNOSED WITH A PSEUDOARTHROSIS AT T8-T9. THE PT UNDERWENT A REVISION SURGERY TO REMOVE ALL OF THE POSTERIOR INSTRUMENTATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TSRH SPINAL SYSTEM HOOKS, RODS, SCREWS KWQ WARSAW ORTHOPAEDIC INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 13 YR Required Intervention