FDA Adverse Event Injury Summary report: N

ORTHOSIS, SPINAL PEDICLE FIXATION, FOR DDD

MDR report key: 3953094 · Received July 23, 2014

Report

Report Number
2520274-2014-12789
Event Type
Injury
Date Received
July 23, 2014
Report Date
June 26, 2014
Manufacturer
SYNTHES USA
Product Code
NKB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS FOR SIX UNKNOWN LOCKING CAPS/UNKNOWN LOTS. IT IS UNKNOWN IF THESE LOCKING CAPS WERE EXPLANTED OR REMAIN IN THE PATIENT. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS.IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT A REVISION EXPLORATION WAS PERFORMED OF A L3-S1 POSTERIOR LUMBAR FUSION DONE WITH MATRIX. THE PATIENT WAS COMPLAINING OF SIGNIFICANT LEG PAIN, ROUGHLY SEVEN WEEKS POST OPERATIVELY. UPON EXPLORATION THE SURGEON ELECTED TO REMOVE THE CAPS AND SACRAL SCREWS ON THE RIGHT AND LEFT AS WELL AS THE LEFT AND RIGHT L3 SCREWS. BOTH WERE UPSIZED AND REPLACED. THE SURGEON DETERMINED THE S1 SCREWS BILATERALLY WERE LOOSE, BUT HE WAS UNABLE TO DETERMINE IF THAT WAS THE REASON FOR THE LEG PAIN. THE SURGEON DECOMPRESSED THE NERVE COMPLETELY. A TOTAL OF FOUR SCREWS WERE REPLACED. THIS REPORT IS FOR SIX UNKNOWN LOCKING CAPS. THIS IS REPORT 3 OF 5 FOR (B)(4).

Description of Event or Problem · 1

THE LOCATION OF THE SIX LOCKING CAPS WAS REPORTED TO BE L3, L4 AND L5.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
432393 ORTHOSIS, SPINAL PEDICLE FIXATION, FOR DDD NKB SYNTHES USA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention