FDA Adverse Event Injury Summary report: N

INFUSE BONE GRAFT

MDR report key: 3965084 · Received July 29, 2014

Report

Report Number
1030489-2014-03346
Event Type
Injury
Date Received
July 29, 2014
Report Date
April 28, 2015
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
NEK
PMA / PMN Number
P000058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, 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.

Additional Manufacturer Narrative · 1

UPDATED INFORMATION: "IT WAS REPORTED THAT ON (B)(6) 2009: THE PATIENT UNDERWENT FUSION SURGERY. FOLLOWING IMPLANTS WERE USED: INFUSE BONE GRAFT. MASTERGRAFT. FLOSEAL HEMOSTATIC MATRIX (BAXTER HEALTH FOUNDATION). CRUSHED CANCELLOUS X4 (MUSCULOSKELETAL TRANSPLANT FOUNDATION)".

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT DEVELOPED UNSPECIFIED INJURIES FOLLOWING THE USE OF RHBMP-2/ACS IN AN UNSPECIFIED SPINAL FUSION SURGERY. NO ADDITIONAL INFORMATION WAS REPORTED.

Description of Event or Problem · 1

"IT WAS REPORTED THAT ON (B)(6) 2009: THE PATIENT UNDERWENT FUSION SURGERY. FOLLOWING IMPLANTS WERE USED: INFUSE BONE GRAFT. MAS TERGRAFT. FLOSEAL HEMOSTATIC MATRIX (BAXTER HEALTH FOUNDATION). CRUSHED CANCELLOUS X4 (MUSCULOSKELETAL TRANSPLANT FOUNDATION)."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
441171 INFUSE BONE GRAFT FILLER, RECOMBINANT HUMAN BONE MORPHOGENETIC PROTEIN, COLLAGEN SCAFFOLD WITH MET NEK MEDTRONIC SOFAMOR DANEK USA, INC NA M110807AAJ

Patients

Seq Age Sex Outcome Treatment
1 Other