FDA Adverse Event
Injury
Summary report: N
INFUSE BONE GRAFT
MDR report key: 3923813
·
Received July 9, 2014
Report
- Report Number
- 1030489-2014-03181
- 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 SEEKING TREATMENT FOR BACK PAIN. IN (B)(6) 2006, SURGEON PERFORMED A SPINAL FUSION SURGERY AT L5 USING RHBMP-2/ACS. FOLLOWING THE SURGERY, PATIENT'S PAIN BECAME WORSE AND WAS NON-STOP. AS A RESULT, PATIENT CONTINUES TO LIVE WITH CONSTANT AND EXCRUCIATING PAIN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 401959 | 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 |