inforMED
InjuryKWQ

OPTERYX

Received Dec 23, 2009 · Event occurred Dec 2, 2009

Report 3004719693-2009-00004 · MDR key 1565675

Device

Generic name

Cervical Plate

Manufacturer

Innovasis, Inc.

Model number

13MM VARIABLE X 4

Catalog number

CP2013

Lot number

0704

Product problems

  • Break
  • Detachment Of Device Component

Patient

34 YR

  • Fall
  • Neck Pain

Narrative

Additional Manufacturer Narrative

ADD'L LOT NUMBER 0801.

Description of Event or Problem

IN 2009, OUR DISTRIBUTOR REPORTED THAT HE WAS SENDING 4 BROKEN SCREWS, THREE UNBROKEN SCREWS AND A CERVICAL PLATE THAT HAD BEEN REMOVED FROM A PT. REVISION SURGERY HAD APPARENTLY BEEN PERFORMED IN MID NOVEMBER AFTER PT REPORTED NECK PAIN FOR SEVERAL WEEKS AFTER FALLING, APPROX EARLY OCTOBER. ORIGINAL FUSION SURGERY HAD BEEN EIGHT MONTHS AGO. X-RAY PRIOR TO REVISION SURGERY WAS RECEIVED AT INNOVASIS DAY OF REPORT. THIS SHOWED THE CERVICAL PLATE WITH BROKEN SCREWS AND THE LOWER PORTION OF THE PLATE SEPARATED FROM THE VERTEBRAE.