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 2020-02-26 for KYPHON HV-R BONE CEMENT C01A manufactured by Medtronic Sofamor Danek Usa, Inc.
[181182101]
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. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[181182102]
Pre-op diagnosis: primary osteoporosis. Type of fracture: compression fracture (intravertebral clefts). It was reported that the patient underwent balloon kyphoplasty. Intra-op, after setting the cement on both sides, and when checking for the solidification of the cement on the left side with bone filler device, the doctor felt strange. When the image was checked, it was found that the cement had dislocated to the front, inside from the initial setting site. There was no deviation from the vertebral body. It was felt that maybe because front wall was damaged, the cement was pushed out. The procedure was continued and finished without additional filling of cement due to concerns about further extrusion. It was unknown whether there were any patient complications or not.
Patient Sequence No: 1, Text Type: D, B5
[187455276]
If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[187455277]
The cement had been mixed properly and had been filled in a uniform softness without any viscosity problems. There had been no migration since the migration that occurred initially. Currently, no complications have occurred.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1030489-2020-00224 |
| MDR Report Key | 9757576 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-02-26 |
| Date of Report | 2020-03-23 |
| Date of Event | 2020-01-28 |
| Date Mfgr Received | 2020-03-16 |
| Date Added to Maude | 2020-02-26 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | STACIE ZIEMBA |
| Manufacturer Street | 1800 PYRAMID PLACE |
| Manufacturer City | MEMPHIS TN 38132 |
| Manufacturer Country | US |
| Manufacturer Postal | 38132 |
| Manufacturer Phone | 9013963133 |
| Manufacturer G1 | MEDTRONIC SOFAMOR DANEK USA, INC |
| Manufacturer Street | 4340 SWINEA RD |
| Manufacturer City | MEMPHIS TN 38118 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 38118 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | KYPHON HV-R BONE CEMENT |
| Generic Name | CEMENT, BONE, VERTEBROPLASTY |
| Product Code | NDN |
| Date Received | 2020-02-26 |
| Model Number | NA |
| Catalog Number | C01A |
| Lot Number | UNK |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDTRONIC SOFAMOR DANEK USA, INC |
| Manufacturer Address | 4340 SWINEA RD MEMPHIS TN 38118 US 38118 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-02-26 |