FDA Adverse Event Injury Summary report: N

ROD

MDR report key: 2423177 · Received January 13, 2012

Report

Report Number
2520274-2012-00055
Event Type
Injury
Date Received
January 13, 2012
Report Date
December 19, 2011
Manufacturer
SYNTHES (USA)
Product Code
NQP
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS ONGOING; NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED OR LOT NUMBER PROVIDED.

Description of Event or Problem · 1

PATIENT UNDERWENT AN L4-S1 PLIF PROCEDURE ON AN UNKNOWN DATE. PATIENT EXPERIENCED ADJACENT LEVEL DISC DISEASE AT L3-L4 AND THE ENTIRE CONSTRUCT WAS REMOVED FROM L4-S1. SURGEON REMOVED SCREWS, LOCKING CAPS AND RODS ON (B)(6) 2011. PATIENT REVISED FROM L3-S1 WITH SCREWS, LOCKING CAPS AND RODS. SURGEON WAS UNABLE TO IMPLANT THE RIGHT L4 SCREW AND COMPLETED REVISION PROCEDURE WITHOUT SCREW. HARDWARE NOT AVAILABLE FOR RETURN. THIS IS THE 14TH OF 14 REPORTS SUBMITTED ON THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ROD NQP SYNTHES (USA)

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention RODS| SCREWS| LOCKING CAPS