FDA Adverse Event
Injury
Summary report: N
4WEB POSTERIOR SPINE TRUSS SYSTEM
MDR report key: 19129320
·
Received April 17, 2024
Report
- Report Number
- 3009189869-2024-00006
- Event Type
- Injury
- Date Received
- April 17, 2024
- Date of Event
- March 25, 2024
- Report Date
- April 17, 2024
- Manufacturer
- 4WEB, INC.
- Product Code
- MAX
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
NO PRODUCT WAS RETURNED FOR EVALUATION NOR RADIOGRAPHS PROVIDED. NO INVESTIGATION COULD BE PERFORMED WITH THE INFORMATION REPORTED. THE CAUSE OF THE EVENT COULD NOT BE ESTABLISHED WITH THE INFORMATION AVAILABLE TO THE MANUFACTURER. A SUPPLEMENTAL REPORT WILL BE FILED AS NEW INFORMATION BECOMES AVAILABLE.
Description of Event or Problem · 0
IT WAS REPORTED TO 4WEB MEDICAL THAT TWO POSTERIOR SPINE TRUSS IMPLANTS NEEDED REVISON SURGERY. THE INTERBODIES HAD TO BE REMOVED AS PATIENT DEVELOPED INFECTION. THE REVISION SURGERY WAS PERFORMED ON (B)(6) 2024. THE COMPLAINANT BELIEVES THE INFECTION IS UNRELATED TO THE HARDWARE. (DEVICE 2 OF 2).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 499249 | 4WEB POSTERIOR SPINE TRUSS SYSTEM | INTERBODY FUSION DEVICE, | MAX | 4WEB, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Male | Required Intervention |