FDA Adverse Event Other Summary report: N

STAY FUSE

MDR report key: 758956 · Received September 6, 2006

Report

Report Number
2030833-2006-00007
Event Type
Other
Date Received
September 6, 2006
Date of Event
July 14, 2006
Report Date
September 5, 2006
Manufacturer
NEXA ORTHOPEDICS
Product Code
KWH
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

510 K INITIALLY GRANTED TO PIONEER SURGICAL TECHNOLOGY. NEXA PURCHASED PRODUCT LINE FROM PIONEER IN 2005.

Description of Event or Problem · 1

PT PRESENTED FOR FOLLOW-UP AFTER IMPLANTATION OF STAY FUSE DEVICE. RADIOGRAPHS AT FOLLOW-UP INDICATED SEPARATION OF STAY FUSE DEVICES. SURGEON, IN 2006, EXPLANTED ONE HALF OF STAY FUSE PAIR AND REPLACED EXPLANTED COMPONENT WITH A NEW DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STAY FUSE TOE FUSION DEVICE KWH NEXA ORTHOPEDICS UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 62 YR Other