FDA Adverse Event Other Summary report: N

LANX SPINAL FIXATION SYSTEM

MDR report key: 3060470 · Received April 11, 2013

Report

Report Number
3004485144-2013-00013
Event Type
Other
Date Received
April 11, 2013
Date of Event
March 26, 2013
Report Date
April 10, 2013
Manufacturer
LANX, INC.
Product Code
KWP
PMA / PMN Number
071877
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

METHOD: NO TESTING METHODS PERFORMED (RELATED DEVICE WAS NOT RETURNED TO MANUFACTURER). LABELING EVALUATION PERFORMED. THE IFU NOTES PSEUDOARTHROSIS AS A POSSIBLE SURGICAL COMPLICATION. RESULTS: NO RESULTS AVAILABLE SINCE NO EVALUATION PERFORMED (RELATED DEVICE WAS NOT RETURNED TO MANUFACTURER). CONCLUSION: KNOWN INHERENT RISK OF PROCEDURE.

Description of Event or Problem · 1

A PATIENT UNDERWENT A REVISION SURGERY TO ADDRESS PSEUDARTHROSIS DEVELOPED AFTER A LANX INTERSPINOUS PROCESS DEVICE WAS IMPLANTED ON (B)(6) 2012. DURING THE REVISION SURGERY, THE SURGEON REMOVED THE LANX INTERSPINOUS PROCESS DEVICE AND REPLACED IT WITH PEDICLE SCREWS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
156905 LANX SPINAL FIXATION SYSTEM INTERSPINOUS PROCESS SPINAL SYSTEM KWP LANX, INC. 6201-0012

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention