inforMED
InjuryNKP

REVOLVE LOCKING CAP

Received Feb 3, 2016 · Event occurred Jan 12, 2016

Report 3004142400-2016-00003 · MDR key 5418980

Device

Generic name

Revolve Locking Cap

Model number

185.000

Product problems

  • Migration or Expulsion of Device

Patient

61 YR

  • No Code Available
  • No Code Available

Narrative

Additional Manufacturer Narrative

A COMPREHENSIVE INVESTIGATION WAS IMMEDIATELY INITIATED ON RECEIPT OF THE COMPLAINT. THE PRODUCT WAS NOT RETURNED FOR EVALUATION. A THOROUGH REVIEW COULD NOT BE CONDUCTED AS NO LOT NUMBER WAS PROVIDED. BASED ON THE INFO PROVIDED, IT IS MOST PROBABLE THE ROD BECAME DISLODGED AS A RESULT OF THE LOCKING CAP NOT BEING PROPERLY TIGHTENED ON THE ROD. HOWEVER, WITHOUT THE IMPLANTS TO EVALUATE, NO DEFINITIVE CONCLUSION CAN BE DETERMINED. IF ADD'L INFO IS PROVIDED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED TO GLOBUS THAT A PT HAD A REVISION SURGERY DUE TO A ROD HAVING MOVED OUT OF SCREW TULIP. THE REVISION SURGERY TOOK PLACE (B)(6) 2016.