FDA Adverse Event Other Summary report: N

LANX SPINAL FIXATION SYSTEM

MDR report key: 2757790 · Received September 17, 2012

Report

Report Number
3004485144-2012-00035
Event Type
Other
Date Received
September 17, 2012
Date of Event
August 16, 2012
Report Date
August 19, 2012
Manufacturer
LANX, INC.
Product Code
MNI
PMA / PMN Number
043484
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PHYSICIAN ASSISTANT

Narratives

Additional Manufacturer Narrative · 1

THE ASSOCIATED INSTRUCTIONS FOR USE LISTS EARLY OR LATE IMPLANT BENDING, BREAKAGE, OR FAILURE AS POSSIBLE COMPLICATIONS.

Description of Event or Problem · 1

THE PT UNDERWENT A REVISION SURGERY TO ADDRESS NON-UNION AND REMOVE TWO BROKEN PEDICLE SCREWS. THE CONSTRUCT WAS ORIGINALLY IMPLANTED ON (B)(6) 2011 AND WAS REPLACED WITH ALL NEW HARDWARE DURING THE REVISION. PT FACTORS, INCLUDING SMOKING, OBESITY, AND NON-COMPLIANCE WITH POST-OP ACTIVITY RESTRICTIONS, ARE BELIEVED TO HAVE CONTRIBUTED TO THE NON-UNION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LANX SPINAL FIXATION SYSTEM PEDICLE SCREW SPINAL SYSTEM MNI LANX, INC.

Patients

Seq Age Sex Outcome Treatment
1 28 YR Required Intervention PLIF CAGE: (B)(4)| RODS AND SET SCREWS: (B)(4)