FDA Adverse Event Injury Summary report: N

VALEO PL

MDR report key: 2116442 · Received June 1, 2011

Report

Report Number
3005032068-2011-00003
Event Type
Injury
Date Received
June 1, 2011
Date of Event
July 16, 2009
Report Date
May 27, 2011
Manufacturer
AMEDICA CORP.
Product Code
MQP
PMA / PMN Number
K073505
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVENT REPORTED BY REQUEST OF FDA.

Description of Event or Problem · 1

TWO VALEO PL SPACERS WERE REVISED AND REMOVED DUE TO IMPLANT MIGRATION WITHIN THE DISC SPACE. THE SURGEON STATED THAT THE PT HAD HORRIBLE BONE. THE PT DENIED TRAUMA. THE SURGEON SUSPECTS TRAUMA, BECAUSE DURING THE REVISION SURGERY, IT WAS OBSERVED THAT THE PT HAD BRUISING ON THE LEGS AND BUTTOCKS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VALEO PL VERTEBRAL BODY REPLACEMENT MQP AMEDICA CORP. VALEO PL 900381

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R