FDA Adverse Event Malfunction Summary report: N

KYPHX HV-R BONE CEMENT

MDR report key: 9719448 · Received February 18, 2020

Report

Report Number
2953769-2020-00004
Event Type
Malfunction
Date Received
February 18, 2020
Date of Event
January 22, 2020
Report Date
February 18, 2020
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 PERCUTANEOUS KYPHOPLASTY SURGERY AT T12 DUE TO PRIMARY OSTEOPOROSIS AND COMPRESSION FRACTURE. INTRA-OP DURING CEMENT FILLING, THE CEMENT WAS LEAKED TO THE SIDE OF THE VERTEBRAL BODY WHEN CHECKING FROM THE FRONTAL SIDE. IT LEAKED ABOUT 0.2CC. THE VERTEBRAL BODY WAS FISH VERTEBRA AND SOLIDIFICATION WAS CHECKED. IT WAS CONSIDERED THAT THE CEMENT LEAKED BECAUSE THE BALLOON DID NOT INFLATE TOO MUCH AND THE CAVITY COULD NOT BE MADE. THE PROCEDURE WAS COMPLETED SUCCESSFULLY BY USING THE ALLEGED PRODUCT. NO PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
184384 KYPHX HV-R BONE CEMENT CEMENT, BONE, VERTEBROPLASTY NDN MDT KYPHON NEUCHATEL MFG NA EL70122

Patients

Seq Age Sex Outcome Treatment
1 74 YR