MIS TI CFX FEN POLY 7X45
Received Nov 17, 2021 · Event occurred Sep 15, 2021
Report 1526439-2021-02429 · MDR key 12830314
Device
Generic name
Bone Cement, Posterior Screw Augmentation
Manufacturer
Depuy Spine IncCatalog number
186727745S
Product problems
- Adverse Event Without Identified Device or Use Problem
- Adverse Event Without Identified Device or Use Problem
Patient
75 YR · Female
- Insufficient Information
- Insufficient Information
Narrative
Additional Manufacturer Narrative
DEPUY SYNTHES IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH DEPUY SYNTHES HAS NOT BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY FDA, DEPUY SYNTHES OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE DEVICE, DEPUY SYNTHES, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF THE INFORMATION IS UNKNOWN, NOT AVAILABLE OR DOES NOT APPLY, THE SECTION/FIELD OF THE FORM IS LEFT BLANK. H10 ADDITIONAL NARRATIVE: INVESTIGATION SUMMARY PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND PREVENTATIVE ACTION IS PROPOSED. THIS COMPLAINT WILL BE ACCOUNTED FOR AND MONITORED VIA POST MARKET SURVEILLANCE ACTIVITIES. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE.
Additional Manufacturer Narrative
ADDITIONAL PROCODE: MNI. COMPLAINANT PART IS NOT EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION. FAX NUMBER REPORTED AS (B)(6). WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. THIS COMPLAINT WILL BE ACCOUNTED FOR AND MONITORED VIA POST MARKET SURVEILLANCE ACTIVITIES. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.
Description of Event or Problem
IT WAS REPORTED THAT DURING A LUMBAR SPINAL REVISION ON (B)(6) 2021, THE PATIENT PASSED AWAY. THE PROCEDURE WAS INTENDED TO REVISE A T12-L5 CONSTRUCT AND EXTEND THE CONSTRUCT TO T9. THE REVISION WAS TO ADDRESS SCREW PULL OUT ON THE RIGHT SIDE OF T12 AND L1. THE PATIENT HAD PREVIOUS LUMBAR SURGERIES. RADIOGRAPHS INDICATED THE PATIENT MAY HAVE ANTERIOR LUMBAR INTERBODY FUSIONS (ALIFS) AND POSTERIOR FIXATION FROM L2-L5 WITH THE CLICK-X SYSTEM. A SUBSEQUENT SURGERY EXTENDED THE CONSTRUCT TWO ADDITIONAL LEVELS TO T12. IN THIS PROCEDURE, THE SURGEON DECIDED TO EXTEND THE CONSTRUCT THREE ADDITIONAL LEVELS TO T9 AND TO AUGMENT THE VERTEBRAL BODIES WITH CONFIDENCE CEMENT VIA VIPER FENESTRATED SCREWS. EACH LEVEL RECEIVED ABOUT 4-5CC OF CEMENT (~2CC PER SCREW). TOTAL CEMENT USED IS APPROXIMATELY 15CC. THE PROCEDURE WENT AS PLANNED. THE WOUND CLOSURE PROCESS WAS ALMOST COMPLETE, WHEN THE PATIENT WENT INTO CARDIAC ARREST AND DIED. THIS REPORT IS FOR A MIS TI CFX FEN POLY 7X45. THIS IS REPORT 10 OF 10 FOR (B)(4).