FDA Adverse Event Injury Summary report: N

INFUSE BONE GRAFT

MDR report key: 5317524 · Received December 22, 2015

Report

Report Number
1030489-2015-03551
Event Type
Injury
Date Received
December 22, 2015
Report Date
November 23, 2015
Manufacturer
MEDTRONIC SOFAMOR DANEK USA, INC
Product Code
NEK
PMA / PMN Number
P000058
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

(B)(6) (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 ON (B)(6) 2012 THE PATIENT UNDERWENT 1) L3 LAMINECTOMY, MEDIAL FACETECTOMY, BILATERAL FORAMINOTOMY. 2) L4 LAMINECTOMY, MEDIAL FACETECTOMY, BILATERAL FORAMINOTOMY. 3) L3-4 POSTERIOR LUMBAR INTERBODY FUSION. 4) L3-4 POSTEROLATERAL ARTHRODESIS. 5) L3-S1 INTERNAL FIXATION WITH INNOVASIS SPINAL ROD SYSTEM. 6) REMOVAL OF PREVIOUSLY PLACED SEGMENTAL SPINAL ROD SYSTEM WITH INSPECTION OF POSTEROLATERAL FUSION MASS. 7) RESECTION OF EXTRADURAL MASS ON THE LEFT SIDE AT L3-4. 8) HARVEST OF LOCAL BONE GRAFT. 9) UTILIZATION OF BONE MORPHOGENIC PROTEIN IN POSTEROLATERAL FUSION MASS. 10) UTILIZATION OF THE X-BOX EXPANDABLE INTERBODY FUSION BIOMECHANICAL DECVICE AT L3-4. PREOPERATIVE DIAGNOSIS: L3-4 STENOSIS, EXTRADURAL MASS STATUS POST L4-S1 FUSION IN THE PAST. PEROP NOTES: A LAMINECTOMY WAS PERFORMED AT L3-4 DECOMPRESSING THE NERVE ROOTS AND THECAL SAC WIDELY BILATERALLY. THE VERTEBRAL BODIES WERE COMPRESSED WITH THE INTERBODY FUSION DEVICE BEFORE COPIOUSLY WITH HYDROGEN PEROXIDE AND ANTIBIOTIC SOLUTION. LATERAL MASS ALONG WITH THE BMP WERE PALCED IN THESE AREA. DURAGEN WAS PLACED OVER THE DURA. ON AN UNKNOWN DATE POST-OP PATIENT ALLEGED UNSPECIFIED INJURIES DUE TO USE OF RHBMP-2.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
844819 INFUSE BONE GRAFT FILLER, RECOMBINANT HUMAN BONE MORPHOGENETIC PROTEIN, COLLAGEN SCAFFOLD WITH MET NEK MEDTRONIC SOFAMOR DANEK USA, INC NA M111105AAA

Patients

Seq Age Sex Outcome Treatment
1 Other