FDA Adverse Event Injury Summary report: N

PIONEER SURGICAL TECHNOLOGY STREAMLINE TL

MDR report key: 18731509 · Received February 19, 2024

Report

Report Number
1833824-2024-00027
Event Type
Injury
Date Received
February 19, 2024
Report Date
May 16, 2024
Manufacturer
PIONEER SURGICAL TECHNOLOGY
Product Code
NKB
UDI-DI
00846468005573
PMA / PMN Number
K140696
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

DEVICE WAS NOT RETURNED TO RESOLVE SURGICAL FOR INSPECTION. MULTIPLE ATTEMPTS WERE MADE TO GATHER DATA FROM THE REP AS. NO ADDITIONAL INFORMATION OR CONFIRMATION HAS BEEN GIVEN THAT THIS IS A PIONEER SURGICAL TECHNOLOGIES MANUFACTURED PART. THE FOLLOWING SECTIONS OF THIS REPORT HAVE BEEN LEFT BLANK DUE TO THE INFORMATION BEING UNAVAILABLE OR NON-APPLICABLE.

Additional Manufacturer Narrative · 0

DEVICE WAS NOT RETURNED TO RESOLVE SURGICAL FOR INSPECTION. MULTIPLE ATTEMPTS WERE MADE TO GATHER DATA FROM THE REP AS. NO ADDITIONAL INFORMATION OR CONFIRMATION HAS BEEN GIVEN THAT THIS IS A PIONEER SURGICAL TECHNOLOGIES MANUFACTURED PART.

Description of Event or Problem · 0

OUR OEM DISRTIBUTION REP STATED ""XTANT MEDICAL HAS RECEIVED A PRODUCT COMPLAINT FROM THE STREAMLINE TL SPINAL FIXATION SYSTEM, IN WHICH IT WAS REPORTED THAT TWO 5.5MM DIAMETER SCREW IMPLANTS (UNKNOWN PRODUCT CODE/LOT NUMBER) WERE IDENTIFIED AS BROKEN WHICH WILL REQUIRE A REVISION PROCEDURE. XTANT MEDICAL HAS INITIATED COMPLAINT (B)(4) ON THE ISSUE. ATTACHED IS THE IMAGING PROVIDED BY THE COMPLAINT SOURCE. BELOW IS RELEVANT INFORMATION PROVIDED BY THE COMPLAINT SOURCE, PLEASE LET ME KNOW IF YOU HAVE ANY QUESTIONS OR CONCERNS, APPRECIATE THE ASSISTANCE. I AM HOPING TO GATHER SOME ADDITIONAL INCIDENT AND PRODUCT INFORMATION UPON COMPLETION OF THE REVISION PROCEDURE, WHICH HAS YET TO OCCUR BUT WILL PROVIDE ANY ADDITIONAL INFORMATION GATHERED. -INDEX PROCEDURE L4-L5 TLIF PERFORMED (B)(6) 2021. -L5 SCREWS MALFUNCTIONED JANUARY 2024. -REVISION PROCEDURE PLANNED TO REMOVE BROKEN SCREWS AND INNER BODY BECAUSE THE CAGE IS DISPLACED AND GOING INTO THE SPINAL CANAL, DATE TBD" .

Description of Event or Problem · 0

OUR OEM DISTRIBUTION REP STATED ""XTANT MEDICAL HAS RECEIVED A PRODUCT COMPLAINT FROM THE STREAMLINE TL SPINAL FIXATION SYSTEM, IN WHICH IT WAS REPORTED THAT TWO 5.5MM DIAMETER SCREW IMPLANTS (UNKNOWN PRODUCT CODE/LOT NUMBER) WERE IDENTIFIED AS BROKEN WHICH WILL REQUIRE A REVISION PROCEDURE. XTANT MEDICAL HAS INITIATED COMPLAINT 24-009 ON THE ISSUE. ATTACHED IS THE IMAGING PROVIDED BY THE COMPLAINT SOURCE. BELOW IS RELEVANT INFORMATION PROVIDED BY THE COMPLAINT SOURCE, PLEASE LET ME KNOW IF YOU HAVE ANY QUESTIONS OR CONCERNS, APPRECIATE THE ASSISTANCE. I AM HOPING TO GATHER SOME ADDITIONAL INCIDENT AND PRODUCT INFORMATION UPON COMPLETION OF THE REVISION PROCEDURE, WHICH HAS YET TO OCCUR BUT WILL PROVIDE ANY ADDITIONAL INFORMATION GATHERED. INDEX PROCEDURE L4-L5 TLIF PERFORMED (B)(6) 2021. L5 SCREWS MALFUNCTIONED (B)(6) 2024. REVISION PROCEDURE PLANNED TO REMOVE BROKEN SCREWS AND INNER BODY BECAUSE THE CAGE IS DISPLACED AND GOING INTO THE SPINAL CANAL, DATE TBD" . INFORMATION ON THE REVISION "(B)(6) 2024 EXPLANTATION OF L5 HARDWARE, SET SCREWS, AND RODS. PLACEMENT OF PEDICLE SCREWS, BILATERAL S1. EXPLANTATION OF PROTRUDING RIGHT L4-5 INTERBODY GRAFT. RIGHT L4-5 FACETECTOMY. L4-5 INTERBODY FUSION USING TRINITY AND MORCELLATED AUTOGRAFT. POSTERIOR INSTRUMENTATION AND FUSION L4-5, L5-S1 BILATERALLY USING RTI PEDICLE SCREWS AND RODS. POSTEROLATERAL FUSION BILATERAL L4-5, L5-S1 USING TRINITY AND MORCELLATED AUTOGRAFT".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
389411 PIONEER SURGICAL TECHNOLOGY STREAMLINE TL THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM NKB PIONEER SURGICAL TECHNOLOGY 01-PA-55-45 371916 00846468005573

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other