INFUSE BONE GRAFT, XX-SMALL KIT 7510050

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2009-12-18 for INFUSE BONE GRAFT, XX-SMALL KIT 7510050 manufactured by Medtronic Sofamor Danek Usa, Inc..

Event Text Entries

[1394004] It was reported that the patient suffered a metacarpal fracture while boxing. An orif was performed at the time. At an unk time post-op, a second surgery was conducted due to non union and plate fracture. During this procedure, rhbmp-2/acs was used around the non-union and also placed into the screw holes. The surgeon reports that he has subsequently seen several lytic lesions approximating half the width of the metacarpal at the sites of the screws. He reports seeing healing supra-cortically at the fracture site.
Patient Sequence No: 1, Text Type: D, B5


[8322903] Products from multiple manufacturers were implanted during the procedure. Although it is unk if any of the devices contributed to the reported event, we are filing this mdr for notification purposes. 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


MAUDE Entry Details

Report Number1030489-2009-01213
MDR Report Key1565052
Report Source05
Date Received2009-12-18
Date of Report2009-11-19
Date Mfgr Received2009-11-19
Date Added to Maude2009-12-30
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 ContactCHAD ASHTON
Manufacturer Street1800 PYRAMID PLACE
Manufacturer CityMEMPHIS TN 38132
Manufacturer CountryUS
Manufacturer Postal38132
Manufacturer Phone9013963133
Manufacturer G1MEDTRONIC SOFAMOR DANEK USA, INC.
Manufacturer Street4340 SWINNEA RD.
Manufacturer CityMEMPHIS TN 38118
Manufacturer CountryUS
Manufacturer Postal Code38118
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameINFUSE BONE GRAFT, XX-SMALL KIT
Generic NameINFUSE BONE GRAFT
Product CodeMPW
Date Received2009-12-18
Model NumberNA
Catalog Number7510050
Lot NumberUNK
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC SOFAMOR DANEK USA, INC.
Manufacturer Address4340 SWINNEA RD. MEMPHIS TN 38118 US 38118


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2009-12-18

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