FDA Adverse Event Other Summary report: N

X STOP IPD SYSTEM

MDR report key: 734879 · Received July 13, 2006

Report

Report Number
2953720-2006-00002
Event Type
Other
Date Received
July 13, 2006
Date of Event
June 19, 2006
Report Date
July 13, 2006
Manufacturer
ST. FRANCIS MEDICAL TECHNOLOGIES, INC.
Product Code
NQO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED TO THE COMPANY FOR EVALUATION AND INFORMATION ABOUT THIS EVENT IS LIMITED. NO CONCLUSION CAN BE MADE AT THIS TIME AND NO CONNECTION CAN BE MADE BETWEEN THE REPORTED EVENT AND ANY SHORTCOMING OF THE DEVICE. AS SURGICAL INTERVENTION OCCURRED, AN MDR IS BEING FILED TO DOCUMENT THIS EVENT.

Description of Event or Problem · 1

AN X STOP INTERSPINOUS DECOMPRESSION SPINAL IMPLANT WAS INSERTED AT THE L4-L5 LEVEL; THE PATIENT WAS REPORTED TO HAVE A "DIMINUTIVE" L5 SPINOUS PROCESS. NINE DAYS LATER, PATIENT EXPERIENCED PAIN. A SHIFT IN THE POSITION OF THE IMPLANT WAS NOTED ON X-RAYS. IN 2006, A PROCEDURE WAS PERFORMED TO REPLACE THE IMPLANT WITH A LARGER SIZE X STOP IMPLANT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 X STOP IPD SYSTEM INTERSPINOUS PROCESS PROSTHESIS NQO ST. FRANCIS MEDICAL TECHNOLOGIES, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 Other| R