FDA Adverse Event Injury Summary report: N

IDYS-ALIF

MDR report key: 20687973 · Received November 14, 2024

Report

Report Number
3009962553-2024-00001
Event Type
Injury
Date Received
November 14, 2024
Date of Event
July 10, 2019
Report Date
November 14, 2024
Manufacturer
CLARIANCE SAS
Product Code
OVD
UDI-DI
03700780626922
PMA / PMN Number
K172083
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

A PATIENT REPORTED AN ALLERGIC REACTION FOLLOWING THE IMPLANTATION OF IDYS-ALIF DEVICE DURING A SURGICAL PROCEDURE PERFORMED IN 2019. THE PATIENT EXPERIENCED SYMPTOMS CONSISTENT WITH AN ALLERGIC RESPONSE. THIS CONSTITUTES AN ADVERSE HEALTH EFFECT THAT RESULTS FROM THE USE OF AN IDYS-ALIF DEVICE. THIS EVENT IS REPORTABLE AS AN INJURY.

Additional Manufacturer Narrative · 0

A PATIENT REPORTED AN ALLERGIC REACTION FOLLOWING THE IMPLANTATION OF IDYS-ALIF DEVICE DURING A SURGICAL PROCEDURE PERFORMED IN 2019. THE PATIENT EXPERIENCED SYMPTOMS CONSISTENT WITH AN ALLERGIC RESPONSE. THIS CONSTITUTES AN ADVERSE HEALTH EFFECT THAT RESULTS FROM THE USE OF AN IDYS-ALIF DEVICE. THIS EVENT IS REPORTABLE AS AN INJURY. 01/09/2025: ANALYSIS CONCLUSION - BASED ON AVAILABLE RECORDS, THE IDYS-ALIF CAGE USED WERE CONFORMING TO CLARIANCE'S SPECIFICATION (CONTROL REPORT AND RAW MATERIAL CERTIFICATES). THE POTENTIAL FOR AN ALLERGIC REACTION IS A CONTRA-INDICATION THAT IS ADDRESSED IN THE IFU.

Description of Event or Problem · 0

PATIENT REPORTS AN ALLERGIC REACTION TO THE METAL IN AN IMPLANT USED IN SURGERY.

Description of Event or Problem · 0

PATIENT REPORTS AN ALLERGIC REACTION TO THE METAL IN AN IMPLANT USED IN SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1195764 IDYS-ALIF IDYS-ALIF CAGE 26X32 - H14MM - 14 OVD CLARIANCE SAS H463X-H725Y 03700780626922

Patients

Seq Age Sex Outcome Treatment
1 NA Female Other