FDA Adverse Event Injury Summary report: N

ATLANTIS ANTERIOR CERVICAL PLATE SYSTEM

MDR report key: 2594787 · Received May 31, 2012

Report

Report Number
1030489-2012-00753
Event Type
Injury
Date Received
May 31, 2012
Date of Event
May 2, 2012
Report Date
May 2, 2012
Manufacturer
MEDTRONIC SOFAMOR DANEK PUERTO RICO OPERATIONS
Product Code
KWP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF THE DEVICE HISTORY RECORDS IS NOT POSSIBLE ON (B)(6) 2012 WITHOUT ADDITIONAL DEVICE INFORMATION. A REVIEW OF THE COM PLAINT HISTORY FOR ATLANTIS TRANSLATIONAL PRODUCT FAMILY, CONDUCTED (B)(6) 2012 DID NOT IDENTIFY ANY APPLICABLE COMPLAINT TRENDS FOR THIS FAILURE MODE. A REVIEW OF THE COMPLAINT HISTORY FOR PARTS, 6190077, 3120514 AND 3120315, CONDUCTED ON (B)(6) 2012, DID NOT IDENTIFY ANY APPLICABLE COMPLAINT TRENDS WITH FURTHER EVALUATION OF THE PRODUCT.

Additional Manufacturer Narrative · 1

MEDICAL INTERPRETATION: OFFERED ARE TWO LATERAL VIEWS OF A MULTIPLE LEVEL CERVICAL ANTERIOR CERVICAL DISCECTOMY AND FUSION (ACDF) FROM C3 TO C7. THERE IS A CONGENITAL FUSION AT C2 - C3. INTERBODY SPACERS ARE PRESENT AND IN GOOD POSITION. THE SECOND FILM SHOWS THAT ONE OF THE C3 BONE SCREWS HAS BACKED OUT PARTIALLY, SUGGESTING FAILURE OF THE LOCKING MECHANISM. OVERALL ALIGNMENT REMAINS GOOD.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT ANTERIOR CERVICAL DISCECTOMY AND FUSION (ACDF) FROM C3 TO C7 FOR MYELOPATHY USING A DEVICE. DURING ROUTINE FOLLOW UP VISIT (TWO TO THREE WEEKS POST-OP), X-RAYS SHOWED TWO SCREWS BACKED OUT PAST THE LOCKING MECHANISM. THE SCREWS WERE LOCATED AT THE DISTAL ENDS OF THE PLATE. IMAGING FILMS WERE PROVIDED. THE DOCTOR WILL MONITOR ANY PATIENT COMPLICATIONS AND ASSESS REVISION OF INSTRUMENTATION AS NEEDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLANTIS ANTERIOR CERVICAL PLATE SYSTEM APPLIANCE, FIXATION, SPINAL INTERLAMINAL KWP MEDTRONIC SOFAMOR DANEK PUERTO RICO OPERATIONS 3120315 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 00058 YR