FDA Adverse Event Injury Summary report: N

CD HORIZON SPINAL SYSTEM

MDR report key: 8987431 · Received September 11, 2019

Report

Report Number
1030489-2019-01002
Event Type
Injury
Date Received
September 11, 2019
Report Date
September 11, 2019
Manufacturer
MDT SOFAMOR DANEK PUERTO RICO MFG
Product Code
KWP
PMA / PMN Number
SEE H10
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

OTHER: SUPERFICIAL INFECTION, WOUND NECROSIS, INCREASE IN SYMPTOMS, DEEP INFECTION. THE FOLLOWING PRODUCTS HAVE BEEN USED IN THE SURGERY: PART# 75446545; 510K# K042025; UDI# (B)(4); QTY# 11 PART# 75446550; 510K# K042025; UDI# (B)(4); QTY# 13 PART# 75446555; 510K# K042025; UDI# (B)(4); QTY# 2 PART# 75447540; 510K# K042025; UDI# (B)(4); QTY# 3 PART# 75447545; 510K# K042025; UDI# (B)(4); QTY# 11 PART# 75447550; 510K# K042025; UDI# (B)(4); QTY# 12 PART# 75446540; 510K# K042025; UDI# (B)(4); QTY# 4 PART# 869-011; 510K# K031655; UDI# (B)(4); QTY# 2 PART# 75447555; 510K# K042025; UDI# (B)(4); QTY# 3 ALTHOUGH IT IS UNKNOWN WHETHER THESE PRODUCTS CAUSED OR CONTRIBUTED TO THE REPORTED EVENTS, WE ARE FILLING THIS MDR FOR NOTIFICATION PURPOSE. NEITHER THE DEVICE NOR FILMS OF APPLICABLE IMAGING STUDIES WERE RETURNED TO THE MANUFACTURER FOR EVALUATION. THEREFORE, WE ARE UNABLE TO DETERMINE THE DEFINITIVE CAUSE OF THE REPORTED EVENT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS REPORTED VIA POST-OPERATIVE CLINICAL STUDY (WITH MINIMUM 12 MONTHS FOLLOW-UP) INVOLVING 155 PATIENTS WITH SPONDYLOLISTHESIS (103 PATIENTS), DEGENERATIVE DISC DISEASE (29 PATIENTS), STENOSIS (15 PATIENTS), RETROLISTHESIS (2 PATIENTS), DEGENERATION OF FACETS (3 PATIENTS) AND 3 DIAGNOSED WITH SPONDYLOLYSIS. POST-OP, 9 PATIENTS SUFFERED FROM SUPERFICIAL INFECTION, INCREASE IN SYMPTOMS IN 4 PATIENTS WAS OBSERVED, AND 1 PATIENT HAD WOUND NECROSIS. 6 PATIENTS SUFFERED FROM DEEP INFECTION OUT OF WHICH 2 PATIENTS DIED DUE TO COMPLICATIONS RESULTING FROM DEEP WOUND INFECTIONS. A TOTAL OF 7 PATIENTS UNDERWENT RE-SURGERY DUE TO THE ADVERSE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
784878 CD HORIZON SPINAL SYSTEM APPLIANCE, FIXATION, SPINAL INTERLAMINAL KWP MDT SOFAMOR DANEK PUERTO RICO MFG NA UNK

Patients

Seq Age Sex Outcome Treatment
1 58 YR Other| R