FDA Adverse Event Other Summary report: N

BAXANO IO-FLEX MICROBLADE SHAVER

MDR report key: 2915195 · Received January 10, 2013

Report

Report Number
3006324586-2013-00001
Event Type
Other
Date Received
January 10, 2013
Date of Event
December 14, 2012
Report Date
January 10, 2013
Manufacturer
BAXANO, INC.
Product Code
HAE
PMA / PMN Number
K100958
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE PT UNDERWENT A LEFT L3/4 DISCECTOMY AND DECOMPRESSION USING THE BAXANO IO-FLEX SYS. DURING DECOMPRESSION WITH THE 10 MM BAXANO IO-FLEX MICROBLADE SHAVER DEVICE AT THE LEFT L3/4 FORAMEN, THE SUPERIOR ARTICULATING PROCESS (SAP) FRACTURED. THE SURGEON STATED THAT USE OF A TAYLOR RETRACTOR WHICH HAD BEEN HAMMERED INTO THE LATERAL ASPECT OF THE SAP WHERE IT MEETS THE BASE OF THE TRANSVERSE PROCESS CONTRIBUTED TO THE BONE FRACTURE. THE PT WAS REPORTEDLY DOING FINE POST-PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
15780 BAXANO IO-FLEX MICROBLADE SHAVER RONGEUR, MANUAL HAE BAXANO, INC. IO-MBS10SC 101030

Patients

Seq Age Sex Outcome Treatment
1 52 YR Other