inforMED
InjuryOUR

IFUSE IMPLANT SYSTEM

Received Nov 17, 2022 · Event occurred Oct 15, 2022

Report 3007700286-2022-00008 · MDR key 15815604

Device

Generic name

Sacroiliac Joint Fixation

Manufacturer

Si-bone, Inc.

Model number

N/A

Lot number

N/A

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

75 YR · Male

  • Pseudoaneurysm
  • Pseudoaneurysm

Narrative

Description of Event or Problem

THE PATIENT HAD SI JOINT ARTHRODESIS IN (B)(6) 2022 WHERE THREE IMPLANTS WERE INSTALLED. FIVE DAYS AFTER THE PATIENT'S PROCEDURE THEY WENT TO THE HOSPITAL DUE TO PAIN AND BRUISING. AFTER EVALUATION AND A WORK-UP BY INTERVENTIONAL RADIOLOGY IT WAS DETERMINED THAT THERE WAS A PSEUDO-ANEURYSM OF ONE OF THE BRANCHES OF THE SUPERIOR GLUTEAL ARTERY. THE PATIENT WAS ADMITTED TO THE HOSPITAL AND UNDERWENT ENDOVASCULAR COILING OF THE ARTERY.

Additional Manufacturer Narrative

BASED ON THE INFORMATION PROVIDED, REVIEW OF THE SURGICAL TECHNIQUE MANUAL, IFU, CERTIFICATES OF CONFORMANCE AND FMEA, THERE IS NO INDICATION OF DEVICE FAILURE AND NO INDICATION THAT THE DEVICE WAS OUT OF SPECIFICATION. THE MOST PROBABLE ROOT CAUSE IS THE SURGICAL PROCEDURE. THE SURGEON DETERMINED PSEUDO-ANEURYSM.