FDA Adverse Event Other Summary report: N

X STOP IPD SYSTEM

MDR report key: 795044 · Received November 27, 2006

Report

Report Number
2953720-2006-00007
Event Type
Other
Date Received
November 27, 2006
Date of Event
October 25, 2006
Report Date
November 27, 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
NURSE

Narratives

Additional Manufacturer Narrative · 1

H6: DEVICE NOT RETURNED. NO CONCLUSION CAN BE DRAWN AT THIS TIME.

Description of Event or Problem · 1

ONE 12MM X STOP INTERSPINOUS DECOMPRESSION SPINAL IMPLANT WAS INSERTED AT L4-L5 WHILE THE PATIENT WAS REPORTEDLY IN A PRONE POSITION. IT WAS REPORTED THAT THE SURGEON EXPERIENCED DIFFICULTY PLACING IMPLANT DUE TO SPINAL ANATOMY. A SPINOUS PROCESS FRACTURE OCCURRED AT THE CEPHALED CURVE OF L5. SURGEON PUT PATIENT IN BRACE TO LIMIT MOVEMENT FOR TWO WEEKS FOLLOWING SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 X STOP IPD SYSTEM INTERSPINOUS PROCESS PROTHESIS NQO ST. FRANCIS MEDICAL TECHNOLOGIES, INC. NA 060919

Patients

Seq Age Sex Outcome Treatment
1 * Required Intervention