FDA Adverse Event Malfunction Summary report: N

2520274-2013-10695

MDR report key: 2980208 · Received February 22, 2013

Report

Report Number
2520274-2013-10695
Event Type
Malfunction
Date Received
February 22, 2013
Manufacturer
SYNTHES (USA)
Product Code
MNI
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE (S) LISTED IN THIS REPORT IS (ARE) USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADD'L INFO RECEIVED REGARDING DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. NO SAMPLE WAS RETURNED FOR EVAL. THE LOT NUMBER IS UNK THEREFORE A REVIEW OF THE DEVICE HISTORY RECORD COULD NOT BE COMPLETED. NO CONCLUSION COULD BE DRAWN, AS SAMPLE WAS NOT RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PT PARTICIPATED IN A (B)(6) STUDY OF TREATMENT FOR 1 OR 2 LEVEL DEGENERATIVE DISC DISEASE BETWEEN L2 AND S1. PT WAS IMPLANTED WITH A TPLIF SPACER AT LEVELS L3 L4SIZE & L4 L5 SIZE WITH PEDICLE SCREWS AT L3, L4 & L5. PT WAS ALSO IMPLANTED WITH CLICK-X FOR SUPPLEMENTAL FIXATION. THE PT EXPERIENCED PAIN FOR 132 MONTHS. SURGERY DATE WAS (B)(6) 2005, AND POSTOPERATIVELY PT EXPERIENCED INCREASING BACK PAIN DUE TO FALL, REQUIRING PHYSICAL THERAPY AND OVER THE COUNTER ANTI-INFLAMMATORIES. THIS IS 15 OF 20 REPORTS FOR THE SAME EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
78492 MNI SYNTHES (USA)

Patients

Seq Age Sex Outcome Treatment
1