inforMED
MalfunctionOVD

IDYS-TLIF TIVAC

Received Sep 14, 2023 · Event occurred Aug 15, 2023

Report 3009962553-2023-00003 · MDR key 17746225

Device

Generic name

Idys Tlif Tivac Cage L29mm H09mm,

Manufacturer

Clariance Sas

Catalog number

41532909-S

Lot number

N1A9X-N113Y

Product problems

  • Material Fragmentation
  • Material Fragmentation

Patient

Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

THE SURGEON WAS ON THE PATIENT'S RIGHT AT L4-5 USING A 9MM TI COATED PEEK BANANA CAGE WITH THE 25-DEGREE ANGLED INSERTER. WHILE IMPACTING INTO THE DISC SPACE, BEFORE ARTICULATING THE INSERTER, THE PROXIMAL TANTALUM MARKER PORTION OF THE CAGE BROKE FROM THE REST OF THE CAGE. HE WAS ABLE TO RETRIEVE THE BROKEN PORTION AND REMOVE IT FROM THE DISC SPACE. HE THEN USED A TAMP/PUSHER TO POSITION THE REST OF THE CAGE ACCORDINGLY. THERE WAS NOT A SIGNIFICANT DELAY TO THE CASE, OR ANY HARM DONE TO THE PATIENT BECAUSE OF THE INCIDENT. ALL THE BROKEN PIECES OF THE IMPLANT WERE REMOVED FROM THE PATIENT AND DISCARDED BY THE SURGICAL STAFF AND CAN'T BE SENT BACK FOR ANALYSIS.

Additional Manufacturer Narrative

WHILE IMPACTING THE TLIF CAGE INTO THE DISC SPACE, BEFORE ARTICULATING THE INSERTER, THE PROXIMAL TANTALUM MARKER PORTION OF THE CAGE BROKE FROM THE REST OF THE CAGE. THE SURGEON WAS ABLE TO RETRIEVE THE BROKEN PORTION AND REMOVE IT FROM THE DISC SPACE. THEN, THE SURGEON WAS ABLE TO POSITION THE REST OF THE CAGE ACCORDINGLY. THIS EVENT IS REPORTABLE AS A MALFUNCTION.

Additional Manufacturer Narrative

WHILE IMPACTING THE TLIF CAGE INTO THE DISC SPACE, BEFORE ARTICULATING THE INSERTER, THE PROXIMAL TANTALUM MARKER PORTION OF THE CAGE BROKE FROM THE REST OF THE CAGE. THE SURGEON WAS ABLE TO RETRIEVE THE BROKEN PORTION AND REMOVE IT FROM THE DISC SPACE. THEN, THE SURGEON WAS ABLE TO POSITION THE REST OF THE CAGE ACCORDINGLY. THIS EVENT IS REPORTABLE AS A MALFUNCTION. ON 11/28/2023, THIS MEDWATCH 3500A FILING NOW INCLUDES THE ANALYSIS REPORT FROM THE MANUFACTURER.

Description of Event or Problem

THE SURGEON WAS ON THE PATIENT'S RIGHT AT L4-5 USING A 9MM TI COATED PEEK BANANA CAGE WITH THE 25-DEGREE ANGLED INSERTER. WHILE IMPACTING INTO THE DISC SPACE, BEFORE ARTICULATING THE INSERTER, THE PROXIMAL TANTALUM MARKER PORTION OF THE CAGE BROKE FROM THE REST OF THE CAGE. HE WAS ABLE TO RETRIEVE THE BROKEN PORTION AND REMOVE IT FROM THE DISC SPACE. HE THEN USED A TAMP/PUSHER TO POSITION THE REST OF THE CAGE ACCORDINGLY. THERE WAS NOT A SIGNIFICANT DELAY TO THE CASE, OR ANY HARM DONE TO THE PATIENT BECAUSE OF THE INCIDENT. ALL THE BROKEN PIECES OF THE IMPLANT WERE REMOVED FROM THE PATIENT AND DISCARDED BY THE SURGICAL STAFF AND CAN'T BE SENT BACK FOR ANALYSIS.

Remedial action

  • Replace