FDA Adverse Event Malfunction Summary report: N

KYPHX HV-R BONE CEMENT

MDR report key: 9155117 · Received October 4, 2019

Report

Report Number
2953769-2019-00016
Event Type
Malfunction
Date Received
October 4, 2019
Date of Event
September 11, 2019
Report Date
October 4, 2019
Manufacturer
MDT KYPHON NEUCHATEL MFG
Product Code
NDN
PMA / PMN Number
SEE H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS PART IS NOT APPROVED FOR USE IN THE UNITED STATES; HOWEVER A LIKE DEVICE CATALOG # C01A, 510K # K180700 AND UDI # (B)(4) WAS CLEARED IN THE UNITED STATES. 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 THAT THE PATIENT UNDERWENT BALLOON KYPHOPLASTY (BKP) AT L1 DUE TO PRIMARY OSTEOPOROSIS (COMPRESSION FRACTURE). INTRA-OP, LEAKAGE OF ABOUT 0.1 ML BONE CEMENT WAS FOUND ON THE LEFT LATERAL WALL, DUE TO THIS FILLING OF THE BONE CEMENT WAS GIVEN UP. THE IMAGE WAS SWITCHED FROM SAGITTAL IMAGES TO FRONTAL IMAGES WHEN FILLING THE BONE CEMENT. NO PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
950659 KYPHX HV-R BONE CEMENT CEMENT, BONE, VERTEBROPLASTY NDN MDT KYPHON NEUCHATEL MFG NA EL70110

Patients

Seq Age Sex Outcome Treatment
1