VIPER 2 SCREW

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-05-15 for VIPER 2 SCREW manufactured by Depuy Synthes Spine.

Event Text Entries

[75209113] This complaint was generated from literature review for health authority reporting purposes. The complaint product is not available for the investigation. A supplemental report is not anticipated unless the results of the pms identify a corrective action or additional relevant information. Should the product become available, a physical evaluation will be conducted and a supplemental report filed with the results. 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


[75209114] This report is being filed after the subsequent review of the following literature article: wang, q. Y. , huang, m. G. , ou, d. Q. , xu, y. C. , dong, j. W. , yin, h. D. ,... & rong, l. M. (2017). One-stage extreme lateral interbody fusion and percutaneous pedicle screw fixation in lumbar spine tuberculosis. Journal of musculoskeletal & neuronal interactions, 17(1), 450. N= 1 post-op loosening.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1526439-2017-10363
MDR Report Key6568272
Date Received2017-05-15
Date of Report2017-04-18
Date Mfgr Received2017-04-18
Date Added to Maude2017-05-15
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 G1DEPUY SYNTHES SPINE
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal Code02767
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVIPER 2 SCREW
Generic NameUNKNOWN VIPER SCREW
Product CodeMRW
Date Received2017-05-15
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerDEPUY SYNTHES SPINE
Manufacturer Address325 PARAMOUNT DRIVE RAYNHAM MA 02767 US 02767


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Required No Informationntervention 2017-05-15

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