FDA Adverse Event Injury Summary report: N

TSRH SPINAL SYSTEM

MDR report key: 1636514 · Received March 19, 2010

Report

Report Number
1030489-2010-00319
Event Type
Injury
Date Received
March 19, 2010
Date of Event
March 29, 2001
Report Date
February 19, 2010
Manufacturer
WARSAW ORTHOPEDIC 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). 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 PATIENT UNDERWENT A 12-LEVEL POSTERIOR SPINAL INSTRUMENTATION FOR IDIOPATHIC SCOLIOSIS USING HOOK AND CROSSLINK INSTRUMENTATION. SEVENTEEN MONTHS POST-OP, THE PATIENT WAS DIAGNOSED WITH A PSEUDOARTHROSIS AT L2-L3. THE PATIENT 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 ORTHOPEDIC INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 15 YR Required Intervention