FDA Adverse Event Injury Summary report: N

EIT PLIF

MDR report key: 8460145 · Received March 28, 2019

Report

Report Number
3013730328-2019-00024
Event Type
Injury
Date Received
March 28, 2019
Date of Event
January 12, 2018
Report Date
April 4, 2019
Manufacturer
EIT EMERGING IMPLANT TECHNOLOGIES GMBH
Product Code
MAX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

CORRECTION OF ADDITIONAL MANUFACTURER NARRATIVE: A1-A6. NO FURTHER PATIENT INFORMATION WAS PROVIDED BY COMPLAINANT. AGE AND WEIGHT ARE BEST ESTIMATED. G5: DEVICE NOT MARKETED IN US, BUT SIMILAR DEVICE IS MARKETED. EIT EMERGING IMPLANT TECHNOLOGIES GMBH (EIT) IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH EIT HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY FDA, EIT OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE DEVICE, EIT, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF THE INFORMATION IS UNKNOWN, NOT AVAILABLE OR DOES NOT APPLY, THE SECTION/FIELD OF THE FORM IS LEFT BLANK. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE. CAPA 2018-AUD-010 DRIVEN BY AN AUDIT, PERFORMED BY THE PARENT COMPANY JOHNSON & JOHNSON, IT WAS EVALUATED THAT THE COMPLAINT/INCIDENT ON HAND NEEDS TO BE REPORTED RETROSPECTIVELY.

Additional Manufacturer Narrative · 1

NO FURTHER PATIENT INFORMATION WAS PROVIDED BY COMPLAINANT. AGE AND WEIGHT ARE BEST ESTIMATED. DEVICE NOT MARKETED IN US, BUT SIMILAR DEVICE IS MARKETED. EIT EMERGING IMPLANT TECHNOLOGIES (B)(4) (EIT) IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH EIT HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

TWO EIT CAGES PEI31002 WERE IMPLANTED IN LEVEL L5/S1 ON (B)(6) 2018. WHEN EXAMINING THE PATIENT IN ITS POST SURGERY CONSULTATION, THE SURGEON NOTICED BOTH CAGES HAD MOVED POSTERIORLY CAUSING PAIN FOR THE PATIENT. BOTH CAGES THEREFORE WERE REMOVED ON (B)(6) 2018 AND REPLACED WITH 1MM K2M CASCADIA CAGES. UPON EXAMINING THE CAGES ONCE REMOVED, SURGEON SAID IT LOOKED LIKE THERE WAS NO EVIDENCE OF BONE INTEGRATION AND STEAD A FIBROUS TISSUE HAD FORMED IN AND AROUND IT INSTEAD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
254405 EIT PLIF PLIF CAGE, H 10MM, 22/9, 12° MAX EIT EMERGING IMPLANT TECHNOLOGIES GMBH PEI31002 E17LA0116

Patients

Seq Age Sex Outcome Treatment
1 50 YR Required Intervention