FDA Adverse Event Other Summary report: N

X STOP IPD SYSTEM

MDR report key: 751330 · Received August 10, 2006

Report

Report Number
2953720-2006-00004
Event Type
Other
Date Received
August 10, 2006
Date of Event
August 1, 2006
Report Date
August 10, 2006
Manufacturer
ST. FRANCIS MEDICAL TECHNOLOGIES, INC.
Product Code
NQO
PMA / PMN Number
P040001
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

METHOD: DEVICE NOT RETURNED. RESULTS: NO CONCLUSION CAN BE DRAWN AT THIS TIME. CONCLUSION: NO CONCLUSION CAN BE DRAWN AT THIS TIME.

Description of Event or Problem · 1

PT REPORTED THAT AN X STOP INTERSPINOUS DECOMPRESSION SPINAL IMPLANT WAS INSERTED IN 2006 AT L4-5. A FEW DAYS AFTER THE PROCEDURE, PT EXPERIENCED DISCOMFORT. TWO WEEKS AFTER SURGERY, REPORTEDLY, A DEVICE DISLODGEMENT WAS NOTED ON X-RAY. DATE OF DISLODGEMENT IS UNKNOWN. PT CONCURRENTLY UNDERWENT LAMINECTOMY SURGERY AT THE TIME OF DEVICE REMOVAL.

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 UNK

Patients

Seq Age Sex Outcome Treatment
1 * Required Intervention