FDA Adverse Event Summary report: N

SOFAMOR DANEK MAST QUADRANT ILLUMINATION SYSTEM

MDR report key: 2770205 · Received September 21, 2012

Report

Report Number
2770205
Date Received
September 21, 2012
Date of Event
September 18, 2012
Report Date
September 21, 2012
Manufacturer
MEDTRONIC SOFAMOR DANEK USA
Product Code
FST
Report Source
User Facility report
Reporter Location
FL, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

PATIENT WITH LUMBAR SPINAL STENOSIS WAS UNDERGOING LAMINECTOMY (L4-5) POSTERIOR SPINAL FUSION IN OPERATING ROOM. PATIENT WAS POSITIONED PRONE. SURGEON WAS USING THE QUADRANT ILLUMINATION SYSTEM DURING THE PROCEDURE. REPRESENTATIVE FROM ILLUMINATION SYSTEM MANUFACTURER PRESENT IN OR DURING PROCEDURE. THE ILLUMINATION SYSTEM WAS ATTACHED TO THE STANDARD OR LIGHT SOURCE. DURING THE PROCEDURE, THE DEVICE WAS FOUND TO BE VERY HOT AT THE CONNECTION FROM THE RETRACTOR CONNECTION TO THE LIGHT CORD. DEVICE WAS IMMEDIATELY TAKEN OUT OF SERVICE. PATIENT IMMEDIATELY ASSESSED AND NO INJURY IDENTIFIED. HOWEVER, AT THE TIME OF CLOSURE, AN AREA OF REDNESS WITH ONE SMALL BLISTER WAS NOTED ON THE PATIENT'S RIGHT UPPER BACK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SOFAMOR DANEK MAST QUADRANT ILLUMINATION SYSTEM LIGHT, SURGICAL, FIBEROPTIC FST MEDTRONIC SOFAMOR DANEK USA 9450059 0203995W

Patients

Seq Age Sex Outcome Treatment
1 44 YR