inforMED
InjuryOSH

RESPONSE 5.5/6.0 UNIAXIAL PEDICLE SCREW 6.0MM X 40MM

Received Jan 10, 2019 · Event occurred Oct 31, 2018

Report 3006460162-2019-00002 · MDR key 8237875

Device

Generic name

Pedicle Screw Spinal System, Adolescent Idiopathic Scoliosis

Model number

N/A

Catalog number

00-1300-0640

Lot number

UNKNOWN

Product problems

  • Fracture
  • Fracture

Patient

Not reported

  • No Information
  • No Information

Narrative

Additional Manufacturer Narrative

THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO RELAY ADDITIONAL INFORMATION. REPORTED EVENT WAS UNABLE TO BE CONFIRMED AS LOT NUMBER OF DEVICE INVOLVED IN THE INCIDENT IS UNKNOWN. DHR REVIEW WAS UNABLE TO BE PERFORMED AS THE LOT NUMBER OF THE DEVICE INVOLVED IN THE EVENT IS UNKNOWN. ROOT CAUSE WAS UNABLE TO BE DETERMINED AS THE NECESSARY INFORMATION TO ADEQUATELY INVESTIGATE THE REPORTED EVENT WAS NOT PROVIDED.

Additional Manufacturer Narrative

REFERENCE: (B)(4). REPORT SOURCE: (B)(6). CUSTOMER HAS INDICATED THAT THE PRODUCT WILL NOT BE RETURNED TO ORTHOPEDIATRICS FOR INVESTIGATION. THE INVESTIGATION IS IN PROCESS. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem

IT HAS BEEN REPORTED THAT FOLLOWING A POSTERIOR SPINAL FUSION, THE PATIENT UNDERWENT A REVISION PROCEDURE DUE TO A FRACTURED PEDICLE SCREW. ATTEMPTS HAVE BEEN MADE AND ADDITIONAL INFORMATION ON THE REPORTED EVENT IS UNAVAILABLE AT THIS TIME.