BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INFUSE BONE GRAFT

    MDR report key: 3923600 · Received July 9, 2014

    Report

    Report Number
    1030489-2014-03170
    Event Type
    Injury
    Date Received
    July 9, 2014
    Report Date
    June 18, 2014
    Manufacturer
    MEDTRONIC SOFAMOR DANEK USA, INC
    Product Code
    NEK
    PMA / PMN Number
    P000058
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    ATTORNEY

    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 THE PATIENT WAS DIAGNOSED WITH KYPHOSIS, A DEFORMATION OF THE SPINE, AND WAS NOTED TO HAVE A BILATERAL L5 PARS DEFECT. AT THE TIME, PATIENT HAD NO COMPLAINTS OF ANY PAIN OR LIMITATIONS, AND WAS AN ACTIVE FOOTBALL PLAYER. ON (B)(6) 2008, PATIENT CONSULTED WITH THE SURGEON. ON (B)(6) 2008, PATIENT UNDERWENT A BILATERAL DIRECT PARS REPAIR FROM L5-S1 USING RHBMP-2/ACS "CAUSING HARM." FOLLOWING THE SURGERY, PATIENT WAS NOT ABLE TO RETURN TO HIS NORMAL ACTIVITIES WITHIN THE FOLLOWING YEAR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    399843 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 Other