IMPLANT, FIXATION DEVICE, SPINAL

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,consum report with the FDA on 2017-05-31 for IMPLANT, FIXATION DEVICE, SPINAL manufactured by Synthes (usa).

Event Text Entries

[76311923] (b)(6). Patient weight not available for reporting. 510k: this report is for an unknown spinal implant. Part and lot numbers are unknown; udi number is unknown. It is not verified that device is a synthes manufactured device. Date of explant reported as sometime in (b)(6) 2017. Complainant part is not expected to be returned for manufacturer review/investigation. (b)(6). Without a lot number the device history records review could not be completed. The investigation could not be completed; no conclusion could be drawn, as no product was received. Device was used for treatment, not diagnosis. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[76311924] It was reported that a patient has expressed that her three-level cervical spine fusion at c5, c6, c7, that took place on (b)(6) 2016 was unsuccessful, the implants were infected with (b)(6). The patient underwent a revision procedure this past month on an unknown date. The amount of devices that were removed is unknown and if the patient was revised to other hardware. It is also unknown who manufactured the implants. It was only reported that it could be depuy synthes or depuy spine. Surgical delay or patient harm during the initial and revision procedures are also unknown. This report is for one (1) unknown spine implant this is report 1 of 1 for (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2520274-2017-11751
MDR Report Key6602383
Report SourceCOMPANY REPRESENTATIVE,CONSUM
Date Received2017-05-31
Date of Report2017-05-07
Date Mfgr Received2017-05-07
Date Added to Maude2017-05-31
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 ContactMICHAEL COTE
Manufacturer Street1302 WRIGHTS LANE EAST
Manufacturer CityWEST CHESTER PA 19380
Manufacturer CountryUS
Manufacturer Postal19380
Manufacturer Phone6107195000
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Generic NameIMPLANT, FIXATION DEVICE, SPINAL
Product CodeJDN
Date Received2017-05-31
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSYNTHES (USA)
Manufacturer Address1302 WRIGHTS LANE EAST WEST CHESTER PA 19380 US 19380


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-05-31

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