FDA Adverse Event Injury Summary report: N

INFUSE BONE GRAFT

MDR report key: 3188616 · Received June 25, 2013

Report

Report Number
1030489-2013-02510
Event Type
Injury
Date Received
June 25, 2013
Report Date
May 29, 2013
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
NEK
PMA / PMN Number
P000058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
PATIENT

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.

Description of Event or Problem · 1

IT WAS REPORTED THAT, "I HAD A PLIF ON 2007, WHEN THEY USED [RHBMP-2/ACS] ... FOR MY LS-S1 SURGEON. I HAD BONE GROWTH WHICH REQUIRED A REVISION SURGERY ON 2010."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
288661 INFUSE BONE GRAFT FILLER, RECOMBINANT HUMAN BONE MORPHOGENETIC PROTEIN, COLLAGEN SCAFFOLD WITH MET NEK MEDTRONIC SOFAMOR DANEK USA, INC NA UNK

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention