DYNESYS LIS, STABILIZING CORD, 100 N/A 01.03711.100

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-03-15 for DYNESYS LIS, STABILIZING CORD, 100 N/A 01.03711.100 manufactured by Zimmer Gmbh.

Event Text Entries

[102439176] The manufacturer did not receive the device for investigation as it is still implanted. No surgical report or x-rays were provided for review. Where lot numbers were received for the devices, the device history records were reviewed and found to be conforming. A cause for this specific event cannot be ascertained from the information provided. Additional information has been requested and is currently not available. As soon as additional information become available and/or an investigation result be available, an amended medical device report will be submitted. Zimmer's reference number of this file is (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[102439177] It was reported that during a l4-s1 fusion surgery, the surgeon was not able to tighten the dynesys stabilizing cord. Nevertheless, the cord was used and remains implanted. The surgery was delayed for 30 minutes.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0009613350-2018-00359
MDR Report Key7340627
Report SourceHEALTH PROFESSIONAL
Date Received2018-03-15
Date of Report2018-09-10
Date of Event2017-11-15
Date Mfgr Received2018-09-06
Device Manufacturer Date2016-11-15
Date Added to Maude2018-03-15
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 ContactMS. CHRISTINA ARNT
Manufacturer Street56 E. BELL DR.
Manufacturer CityWARSAW IN 46582
Manufacturer CountryUS
Manufacturer Postal46582
Manufacturer Phone5745273773
Manufacturer G1ZIMMER GMBH
Manufacturer StreetSULZER ALLEE 8 SULZER INDUSTRIE PARK
Manufacturer CityWINTERTHUR 8404
Manufacturer CountrySZ
Manufacturer Postal Code8404
Single Use3
Previous Use Code3
Removal Correction NumberN/A
Event Type3
Type of Report3

Device Details

Brand NameDYNESYS LIS, STABILIZING CORD, 100
Generic NameDYNESYS SPINAL SYSTEM
Product CodeNQP
Date Received2018-03-15
Model NumberN/A
Catalog Number01.03711.100
Lot Number2884765
ID Number00889024482241
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZIMMER GMBH
Manufacturer AddressSULZER ALLEE 8 SULZER INDUSTRIE PARK WINTERTHUR 8404 SZ 8404


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-03-15

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