MAUDE MDR 7275991

MDR report key
7275991
Report number
1030489-2018-00239
Event key
0
Event type
3
Date received
2018-02-16
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
STACIE ZIEMBA
Address
1800 PYRAMID PLACE MEMPHIS TN 38132 US
Phone
901-901-9013
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CENTERPIECE PLATE FIXATION SYSTEMORTHOSIS, SPINE, PLATE, LAMINOPLASTY, METALWARSAW ORTHOPEDICSNQWNAG90100002740567631WN N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-02-1601. O; 2. R

Event Narratives#

N

Patient 1

THIS PRODUCT IS NOT MARKETED IN US BUT A SIMILAR DEVICE WITH CATALOG # 853-465, UDI# (B)(4) AND 510K# K050082 IS APPROVED FOR SALE IN US. PRODUCT WAS NOT RETURNED TO THE MANUFACTURER FOR EVALUATION. THEREFORE, WE ARE UNABLE TO DETERMINE THE DEFINITIVE CAUSE OF THE REPORTED EVENT. THE FOLLOWING PRODUCTS WERE USED IN THE SURGERY: (PRODUCT ID: (B)(4), LOT: 0567631W, QTY: 8). ALTHOUGH IT IS UNKNOWN WHETHER THESE PRODUCTS CAUSED OR CONTRIBUTED TO THE REPORTED EVENT, WE ARE FILLING THIS MDR FOR NOTIFICATION PURPOSE. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

D

Patient 1

IT WAS REPORTED THAT THE PATIENT UNDERWENT LAMINOPLASTY AT C5-C6 DUE TO SPONDYLOTIC MYELOPATHY. POST-OP, THE HINGE (PATIENT'S BODY PART) SIDE OF BOTH C5 AND C6 FRACTURED AND AS A RESULT THE IMPLANTED SCREWS DROPPED INTO THE SPINAL CANAL. PATIENT UNDERWENT REVISION SURGERY FOR REMOVING THE SCREW AND ALSO UNDERWENT POSTERIOR SPINAL FUSION (PSF) SURGERY AT C4-C7 DUE TO KYPHOSIS PROGRESS. THERE WAS NO DEFECTS ON THE IMPLANTS.

N

Patient 1

ADDITIONAL INFORMATION: X-RAY REVIEW RESULT: C5-6 LAMINOPLASTY POST-OP X-RAY AND CT IMAGES WERE PROVIDED. THERE IS A FRACTURE OF THE NON INSTRUMENTED SIDE OF THE LAMINOPLASTY AND TO NOT SEE A SCREW IN THE SPINAL CORD ON THE PROVIDED IMAGES. LIKELY CAUSE OF HARDWARE FRACTURE IS PROGRESSION OF DEFORMITY IN THE CONSTRUCT WHERE FUSION IS NOT EXPECTED TO OCCUR. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.