FDA Adverse Event Malfunction Summary report: N

KYPHX HV-R BONE CEMENT

MDR report key: 9178522 · Received October 11, 2019

Report

Report Number
2953769-2019-00017
Event Type
Malfunction
Date Received
October 11, 2019
Date of Event
September 13, 2019
Report Date
October 11, 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 SPINAL FUSION SURGERY DUE TO PRIMARY OSTEOPOROSIS (COMPRESSION FRACTURE). INTRA-OP, CEMENT LEAKED FROM THE LEFT LATERAL WALL OF BONE FILLER DEVICE (BFD). FILLING OF CEMENT WAS STOPPED AT THAT STAGE. THE PROCEDURE WAS HOWEVER COMPLETED WITH THE SAME CEMENT; AND NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
976606 KYPHX HV-R BONE CEMENT CEMENT, BONE, VERTEBROPLASTY NDN MDT KYPHON NEUCHATEL MFG NA EL70110

Patients

Seq Age Sex Outcome Treatment
1