FDA Adverse Event Injury Summary report: N

INFUSE BONE GRAFT

MDR report key: 2830049 · Received November 13, 2012

Report

Report Number
1030489-2012-02109
Event Type
Injury
Date Received
November 13, 2012
Report Date
August 15, 2016
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
NEK
PMA / PMN Number
P000058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

(B)(4): NEITHER THE DEVICE NOR FILMS OF APPLICABLE IMAGING STUDIES WERE RETURNED TO THE MANUFACTURER FOR EVALUATION. THEREFORE, WE ARE UNABLE TO DETERMINE THE DEFINITIVE CAUSE OF THE REPORTED EVENT. PRODUCTS FROM MULTIPLE MANUFACTURERS WERE IMPLANTED DURING THE PROCEDURE. ALTHOUGH IT IS UNKNOWN IF ANY OF THE DEVICES CONTRIBUTED TO THE REPORTED EVENT, WE ARE FILING THIS MDR FOR NOTIFICATION PURPOSES.

Additional Manufacturer Narrative · 1

A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT ALLEGEDLY SUSTAINED UNSPECIFIED INJURIES RESULTING FROM SURGERY USING RHBMP-2/ACS. NO FURTHER DETAILS HAVE BEEN PROVIDED.

Description of Event or Problem · 1

IT WAS REPORTED THAT ON (B)(6) 2007, THE PATIENT UNDERWENT L3-4 LUMBAR DECOMPRESSION L4-5 FUSION , ILIAC CREST BONE GRAFTING , TRANSFORAMINAL LUMBAR INTERBODY FUSION. THE PATIENT WAS OPERATED USING RHBMP-2, SPACER , SCREWS AND RODS FROM STRYKER SPINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INFUSE BONE GRAFT FILLER, RECOMBINANT HUMAN BONE MORPHOGENETIC PROTEIN, COLLAGEN SCAFFOLD WITH MET NEK MEDTRONIC SOFAMOR DANEK USA, INC NA M110702AAB

Patients

Seq Age Sex Outcome Treatment
1 53 YR Other