NUVASIVE HELIX-T ACP SYSTEM 7739217 NA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06,07 report with the FDA on 2015-02-18 for NUVASIVE HELIX-T ACP SYSTEM 7739217 NA manufactured by Nuvasive, Inc..

Event Text Entries

[15895386] The initial two level acdf was performed on (b)(6) 2014 to fuse c3-c5 vertebral bodies. During a follow up visit it was noted that the caudal bone screw at c5 had separated from the plate and was noted to be deeply embedded in the vertebral body. Revision surgery was performed on (b)(6) 2015 and the bone screw was easily removed and replaced. The patient is reportedly doing well post revision surgery. Patient's activity level, compliance with post-surgical instructions and bone integrity are unknown.
Patient Sequence No: 1, Text Type: D, B5


[16020118] (b)(4). Radiographs received confirmed the event. Evaluation of the returned bone screw displays distortion of the washing collapsed upon the head of the screw. The washer condition is a result of the screw and washer passing through the plate. Review of the device history records notes no material non-conformance's or manufacturing errors that may have caused or contributed to this mode of failure. The depth of the bone screw in the vertebral body was unusual. It is unknown if the depth was a result of initial placement or post-operative separation. Patient impact/sustained fall, poor bone quality or other factors contributing to a failure are unknown. The root cause of this reported event has not been determined; no conclusion can be drawn.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2031966-2015-00003
MDR Report Key4550828
Report Source05,06,07
Date Received2015-02-18
Date of Report2015-02-18
Date of Event2015-01-01
Date Mfgr Received2015-01-20
Device Manufacturer Date2013-05-17
Date Added to Maude2015-03-26
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactPETER PERHACH
Manufacturer Street7475 LUSK BLVD.
Manufacturer CitySAN DIEGO CA 92121
Manufacturer CountryUS
Manufacturer Postal92121
Manufacturer Phone8589093347
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameNUVASIVE HELIX-T ACP SYSTEM
Generic NameSPINAL INT VERT BODY FIXATION APPLIA
Product CodeJDN
Date Received2015-02-18
Returned To Mfg2015-02-12
Model Number7739217
Catalog NumberNA
Lot NumberNM1711
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerNUVASIVE, INC.
Manufacturer Address7475 LUSK BLVD. SAN DIEGO CA US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2015-02-18

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