FDA Adverse Event Other Summary report: N

LANX SPINAL FIXATION SYSTEM

MDR report key: 3294580 · Received August 13, 2013

Report

Report Number
3004485144-2013-00029
Event Type
Other
Date Received
August 13, 2013
Date of Event
July 16, 2013
Report Date
August 9, 2013
Manufacturer
LANX, INC.
Product Code
MNI
PMA / PMN Number
071877
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

REVIEW OF THE ASSOCIATED DHR FOUND NO DEVICE NONCONFORMITIES THAT MIGHT HAVE CONTRIBUTED TO THE EVENT. THE PRODUCT LABELING IDENTIFIES PSEUDARTHROSIS AS POSSIBLE COMPLICATIONS ASSOCIATED WITH USE OF THE DEVICE.

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
388432 LANX SPINAL FIXATION SYSTEM INTERSPINIOUS PROCESS SPINAL SYSTEM MNI LANX, INC. 6201-0008-001

Patients

Seq Age Sex Outcome Treatment
1 53 YR Required Intervention