FDA Adverse Event
Injury
Summary report: N
CD SPINAL FIXATION SYSTEM
MDR report key: 224167
·
Received May 19, 1999
Report
- Report Number
- 1030489-1999-00068
- Event Type
- Injury
- Date Received
- May 19, 1999
- Date of Event
- December 12, 1989
- Report Date
- April 20, 1999
- Manufacturer
- SOFAMOUR DANEK EUROPE
- Product Code
- KWP
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MD, US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
IMPLANT DATE: 06/02/1987. PT COMPLAINED OF PAIN. REVISION SURGERY ON 12/12/1989 TO REMOVE DEVICE AT WHICH TIME IT WAS FOUND THAT THE CONSTRUCT WAS LOOSE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CD SPINAL FIXATION SYSTEM Implant | SPINAL FIXATION SYSTEM | KWP | SOFAMOUR DANEK EUROPE | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 57 YR | Required Intervention |