FDA Adverse Event Other Summary report: N

X STOP IPD SYSTEM

MDR report key: 795139 · Received November 28, 2006

Report

Report Number
2953720-2006-00008
Event Type
Other
Date Received
November 28, 2006
Report Date
November 28, 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
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

H6: DEVICE NOT RETURNED. NO CONCLUSION CAN BE DRAWN AT THIS TIME. DATE OF EVENT IS UNK.

Description of Event or Problem · 1

ONE X STOP INTERSPINOUS DECOMPRESSION SPINAL IMPLANT WAS INSERTED AT L4-L5 IN 2006. PATIENT COMPLAINED OF A RETURN OF STENOSIS SYMPTOMS AT THE 3 WEEKS POSTOPERATIVE VISIT AT WHICH TIME A SPINOUS PROCESS FRACTURE AT L5 WAS CONFIRMED BY X-RAY. IT WAS REPORTED THAT PATIENT HAS ELECTED TO UNDERGO FURTHER DECOMPRESSION SURGERY AT WHICH TIME THE IMPLANT WILL BE REMOVED.

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 *

Patients

Seq Age Sex Outcome Treatment
1 Other