FDA Adverse Event Injury Summary report: N

INSPACE US MEDIUM

MDR report key: 19486602 · Received June 7, 2024

Report

Report Number
3016573902-2024-00005
Event Type
Injury
Date Received
June 7, 2024
Date of Event
May 13, 2024
Report Date
July 25, 2025
Manufacturer
ORTHOSPACE LTD.
Product Code
QPQ
UDI-DI
17290013396058
PMA / PMN Number
DEN200039
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION WILL BE PROVIDED ONCE THE INVESTIGATION HAS BEEN COMPLETED. THE DEVICE MANUFACTURER DATE IS NOT KNOWN AT THIS TIME. HOWEVER, SHOULD IT BECOME AVAILABLE IT WILL BE PROVIDED IN FUTURE REPORTS.

Additional Manufacturer Narrative · 0

THIS COMPLAINT INVESTIGATION WAS CLOSED BASED ON THE DEVICE NOT RECEIVED, THEREFORE THE REPORTED FAILURE MODE WAS NOT CONFIRMED. IN THE EVENT THAT THE DEVICE IS RECEIVED, THE COMPLAINT WILL BE REOPENED AND THE INVESTIGATION WILL BE UPDATED WITH NEW RESULTS. ALLEGED FAILURE: PATIENT COMPLICATION PROBABLE ROOT CAUSE: PROCESS: SPACER NOT MANUFACTURED TO SPECIFICATION, INCORRECT MATERIAL USED DURING MANUFACTURE, INCORRECT PACKAGING OR ERROR IN PACKAGING PROCESS CAUSES EXPOSURE TO HUMIDITY OR HIGH TEMPERATURES. APPLICATION: USE OF EXPIRED PRODUCT, WRONG STORAGE CONDITIONS, RE-USE OF SINGLE-USE DEVICE, USE OF CONTRAST MEDIA, WRONG PATIENT OR DEVICE SELECTION, PATIENT NOT FOLLOWING REHAB PROCEDURE. THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE. THE MANUFACTURING DATE IS UNKNOWN.

Additional Manufacturer Narrative · 0

CORRECTING PROBABLE ROOT CAUSES LISTED BELOW AS PER QUALITY ENGINEER REVIEW THESE ARE THE MOST APPLICABLE: THIS COMPLAINT INVESTIGATION WAS CLOSED BASED ON THE DEVICE NOT RECEIVED, THEREFORE THE REPORTED FAILURE MODE WAS NOT CONFIRMED. IN THE EVENT THAT THE DEVICE IS RECEIVED, THE COMPLAINT WILL BE REOPENED AND THE INVESTIGATION WILL BE UPDATED WITH NEW RESULTS. ALLEGED FAILURE: PATIENT COMPLICATION PROBABLE ROOT CAUSE: APPLICATION USE OF EXPIRED PRODUCT WRONG STORAGE CONDITIONS RE-USE OF SINGLE-USE DEVICE USE OF CONTRAST MEDIA WRONG PATIENT OR DEVICE SELECTION PATIENT NOT FOLLOWING REHAB PROCEDURE. THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE. THE MANUFACTURING DATE IS UNKNOWN.

Additional Manufacturer Narrative · 0

PER ADDITIONAL REVIEW, THE BELOW IS THE UPDATED INVESTIGATION CONCLUSION. THIS COMPLAINT INVESTIGATION WAS CLOSED BASED ON THE DEVICE NOT RECEIVED, THEREFORE THE REPORTED FAILURE MODE WAS NOT CONFIRMED. IN THE EVENT THAT THE DEVICE IS RECEIVED, THE COMPLAINT WILL BE REOPENED AND THE INVESTIGATION WILL BE UPDATED WITH NEW RESULTS. ALLEGED FAILURE: PATIENT COMPLICATION PROBABLE ROOT CAUSE: APPLICATION - PATIENT REACTION/ALLERGY SENSITIVITY WITH OR - SURGICAL PROCEDURE INTRODUCES ACTIVE/LATENT INFECTION - WRONG PATIENT SELECTION - GENERAL REACTION TO PROCEDURE THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE. STRYKER WILL CONTINUE TO MONITOR FOR ANY REPORTS OR TRENDS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD A SUBCUTANEOUS DEVELOPMENT OF ¿COTTAGE CHEESE¿ TYPE CONSISTENCY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD A SUBCUTANEOUS DEVELOPMENT OF ¿COTTAGE CHEESE¿ TYPE CONSISTENCY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD A SUBCUTANEOUS DEVELOPMENT OF ¿COTTAGE CHEESE¿ TYPE CONSISTENCY.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD A SUBCUTANEOUS DEVELOPMENT OF ¿COTTAGE CHEESE¿ TYPE CONSISTENCY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1436969 INSPACE US MEDIUM SHOULDER SPACER FOR MASSIVE IRREPARABLE ROTATOR CUFF TEAR, RESORBABLE, INFLATAB QPQ ORTHOSPACE LTD. 091123-01 17290013396058

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other