FDA Adverse Event Injury Summary report: N

CAVUX CERVICAL CAGE-B

MDR report key: 8049332 · Received November 7, 2018

Report

Report Number
3009394448-2018-00002
Event Type
Injury
Date Received
November 7, 2018
Report Date
October 10, 2018
Manufacturer
PROVIDENCE MEDICAL TECHNOLOGY
Product Code
ODP
PMA / PMN Number
K122801
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

A PATIENT WAS TREATED AT C6- C7 LEVEL IN A CASE THAT INVOLVED PROVIDENCE PRODUCTS. THE PATIENT LATER EXPERIENCED C7 RADICULAR SYMPTOMS. THE SURGERY WAS REVISED. REVISION SURGERY RESOLVED SYMPTOMS. NO PRODUCT MALFUNCTIONS WERE REPORTED. THE PHYSICIAN NOTED THAT THE CAGES MAY HAVE BEEN MALPOSITIONED AND CAUSED THE SUSPECTED ISSUE. THE PHYSICIAN DECLINED TO PROVIDE ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
888220 CAVUX CERVICAL CAGE-B CERVICAL CAGE ODP PROVIDENCE MEDICAL TECHNOLOGY PD-31-200

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention