TIMESH 853010WM

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2017-01-18 for TIMESH 853010WM manufactured by Warsaw Orthopedics.

Event Text Entries

[65026180] Devices of multiple part/lot numbers were implanted during the procedure including: part: 853010wm / lot: 0463760w (x1) part: 853010wm/ lot: 0463700w (x1); part: 853010wm/ lot: 0438447w (x1); part: 853010wm/ lot: 0106859w (x1); part: 853-467/ lot: 0497212w (x7); part: 853-469 / lot: 0489775w (x9). Although it is unknown if any of these devices contributed to the reported event, we are filing this mdr for notification purposes. (b)(4). 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.
Patient Sequence No: 1, Text Type: N, H10


[65026181] It was reported that on (b)(6) 2016, patient underwent a surgery due to ossification of posterior longitudinal ligament and stenosis of spinal canal. Post-op, patient had neck pain, limb weakness and 0 lower limb muscle strength. Due to which the patient underwent a revision surgery on (b)(6) 2016 in which posterior cervical decompression with vertex internal fixation was performed. The products came in contact with the patient. Patient was also reported with bleeding "after the surgery. " after revision surgery patient had neck pain relief but 0 lower limb muscle strength.
Patient Sequence No: 1, Text Type: D, B5


[98439704] A good faith effort will be made to obtain the applicable information relevant to the report. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1030489-2017-00124
MDR Report Key6259504
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2017-01-18
Date of Report2016-12-23
Date of Event2016-12-20
Date Mfgr Received2016-12-23
Date Added to Maude2017-01-18
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 FDA3
Event Location3
Manufacturer ContactGREG ANGLIN
Manufacturer Street1800 PYRAMID PLACE
Manufacturer CityMEMPHIS TN 38132
Manufacturer CountryUS
Manufacturer Postal38132
Manufacturer Phone9013963133
Manufacturer G1WARSAW ORTHOPEDICS
Manufacturer Street2500 SILVEUS CROSSING
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal Code46582
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTIMESH
Generic NameORTHOSIS, SPINE, PLATE, LAMINOPLASTY, METAL
Product CodeNQW
Date Received2017-01-18
Model NumberNA
Catalog Number853010WM
Lot Number0463760W
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerWARSAW ORTHOPEDICS
Manufacturer Address2500 SILVEUS CROSSING WARSAW IN 46582 US 46582


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-01-18

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