FDA Adverse Event Injury Summary report: N

KYPHX? HV-R? BONE CEMENT

MDR report key: 1904803 · Received November 22, 2010

Report

Report Number
2953769-2010-00580
Event Type
Injury
Date Received
November 22, 2010
Date of Event
October 20, 2010
Report Date
October 20, 2010
Manufacturer
MEDTRONIC SPINE LLC.
Product Code
NDN
PMA / PMN Number
ASKU
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

METHOD - DEVICE NOT RETURNED, FOLLOW UP WOTH COMPANY REPRESENTATIVE.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT UNDERWENT A KYPHOPLASTY PROCEDURE. DURING THE PROCEDURE A PIECE OF HARD CEMENT APPROXIMATELY 6 CM IN LENGTH REMAINED IN THE VERTEBRAL BODY. THE SURGEON MADE AN INCISION TO REMOVE THE CEMENT THREAD. THERE WERE NO PATIENT COMPLICATIONS. NO ADDITIONAL INFORMATION WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KYPHX? HV-R? BONE CEMENT BONE CEMENT NDN MEDTRONIC SPINE LLC. ASKU

Patients

Seq Age Sex Outcome Treatment
1 00071 YR Other| R