FDA Adverse Event Injury Summary report: N

PITUITARY RONGEUR, 2MM

MDR report key: 4925787 · Received July 13, 2015

Report

Report Number
2031966-2015-00039
Event Type
Injury
Date Received
July 13, 2015
Date of Event
January 29, 2015
Report Date
July 13, 2015
Manufacturer
NUVASIVE, INC.
Product Code
HTX
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). REVIEW OF THE DEVICE HISTORY RECORD NOTES NO MATERIAL NON-CONFORMANCES OR MFG ERRORS THAT MAY HAVE CAUSED OR CONTRIBUTED TO THIS MODE OF FAILURE. ROOT CAUSE OF THE REPORTED EVENT IS UNDETERMINED AT THIS TIME. IT IS UNCLEAR IF THE PT'S MEDICAL HISTORY WAS A CONTRIBUTING FACTOR TO THE REPORTED BLOOD LOSS.

Description of Event or Problem · 1

DURING SURGERY ON (B)(6) 2015 AT THE T11-12 SPINE LEVEL, THE RONGEUR REPORTEDLY BROKE AND A FRAGMENT LODGED NEAR THE DURAL SPACE. RETRIEVAL REQUIRED PARTIAL CORPECTOMY. THE PT WAS REPORTED TO HAVE LOST 2.2 LITERS OF BLOOD, NECESSITATING TRANSFUSION AND EXTENDED HOSPITALIZATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
454564 PITUITARY RONGEUR, 2MM HTX NUVASIVE, INC. 6940429 FD3573403

Patients

Seq Age Sex Outcome Treatment
1 69 YR