FDA Adverse Event
Injury
Summary report: N
4WEB LUMBAR SPINE TRUSS SYSTEM
MDR report key: 19494145
·
Received June 8, 2024
Report
- Report Number
- 3009189869-2024-00010
- Event Type
- Injury
- Date Received
- June 8, 2024
- Date of Event
- May 17, 2024
- Report Date
- June 7, 2024
- Manufacturer
- 4WEB, INC.
- Product Code
- OVD
- PMA / PMN Number
- K203065
- 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 TO THE MANUFACTURER. THE CAUSE OF THE MIGRATION COULD NOT BE ESTABLISHED WITH THE INFORMATION AVAILABLE TO THE MANUFACTURER. INFORMATION RECEIVED DID NOT INDICATE AN ISSUE WITH THE DEVICE(S) INVOLVED. THE CAGE REMAINS IMPLANTED IN THE PATIENT. THE SUPPLEMENTAL FIXATION WAS REMOVED AND REPLACED BY A NEW 4WEB SCREWS.
Description of Event or Problem · 0
IT WAS REPORTED TO 4WEB THAT A REVISION SURGERY WAS REQUIRED AS 4WEB ANTERIOR SPINE TRUSS SYSTEM - STAND ALONE CAGE WAS REPORTED TO HAVE MIGRATED ANTERIORLY. PER INFORMATION RECEIVED, IT IS BELIEVED THAT THE PATIENT PRESENTED WITH PAIN ABOUT ONE AND A HALF MONTH POST INITIAL SURGERY. THE INITIAL SURGERY WAS COMPLETED USING 2 4WEB SCREWS AND PLATE AND WAS PERFORMED ON (B)(6) 2024. REPORT TWO OF THREE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2318946 | 4WEB LUMBAR SPINE TRUSS SYSTEM | INTERVERTEBRAL FUSION DEVICE | OVD | 4WEB, INC. | LSCR-5525-NS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 42 YR | Male | Required Intervention |