FDA Adverse Event Injury Summary report: N

ISOBAR SPINAL SYSTEM

MDR report key: 770272 · Received October 13, 2006

Report

Report Number
3003807094-2006-00002
Event Type
Injury
Date Received
October 13, 2006
Date of Event
April 29, 2005
Report Date
May 5, 2005
Manufacturer
SCIENT'X USA, INC.
Product Code
NQP
PMA / PMN Number
k990118
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ROD CUT TOO SHORT DURING SURGERY. ADD'L LOT# 988L.

Description of Event or Problem · 1

IN 2005 PREOP DIAGNOSIS SPINAL STENOSIS WITH LUMBAR INTERVETEBRAL DISC DEGENERATION. THREE MONTHS LATER, SURGICAL TREATMENT L2 - SACRUM LAMINECTOMY; PSF WITH BONEGRAFT AND INSTRUMENTATION. DATE UNK - X-RAY SHOWED A DISLODGED ROD AT S1 SCREWS. ELEVEN DAYS LATER - SURGICAL PROCEDURE TO APPROPRIATELY PLACE CONTOURED RODS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ISOBAR SPINAL SYSTEM PEDICLE SCREW SPINAL SYSTEM NQP SCIENT'X USA, INC. * 546L

Patients

Seq Age Sex Outcome Treatment
1 71 YR Other