UNKNOWN HALO FIXATION PIN UNK ? SPINAL IMPLANT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2016-07-18 for UNKNOWN HALO FIXATION PIN UNK ? SPINAL IMPLANT manufactured by Depuy Synthes Spine.

Event Text Entries

[49812950] Udi: unknown part number, all 3 attempts to obtain product were unsuccessful, udi unavailable. 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


[49812951] During application of a halo fixation system, the halo crown is fixed with 4 pins to the skull. One of these pins got wedged into the crown up to the point where not adequate fixation could be archived. As to how this event was solved is not exactly known yet. I can speak to the treating hcp next week. There was additional anesthesia needed for the skin of the patient and the procedure was lengthened. How much the procedure was lengthened is known at this time. The product as available for examination. This event is not uncommon to this user. Update 06 july 2016 - it seems that the threads in the ring are not correctly cut, as the pin jammed immediately in the ring.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1526439-2016-10498
MDR Report Key5802326
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2016-07-18
Date of Report2016-06-23
Date of Event2016-06-23
Date Mfgr Received2016-06-23
Date Added to Maude2016-07-18
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 ContactJASON BUSCH
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone5088808201
Manufacturer G1MEDOS INTERNATIONAL SARL
Manufacturer StreetCHEMIN BLANC 38
Manufacturer CityLE LOCLE CH-2400
Manufacturer CountrySZ
Manufacturer Postal CodeCH-2400
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN HALO FIXATION PIN
Generic NameCOMPONENT, TRACTION, INVASIVE
Product CodeJEC
Date Received2016-07-18
Catalog NumberUNK ? SPINAL IMPLANT
Lot NumberUNKNOWN
OperatorPHYSICIAN
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerDEPUY SYNTHES SPINE
Manufacturer Address325 PARAMOUNT DRIVE RAYNHAM MA 02767 US 02767


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2016-07-18

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