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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC SOFAMOR DANEK USA, INC TRANSLACE SPINAL TETHERING SYSTEM

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MEDTRONIC SOFAMOR DANEK USA, INC TRANSLACE SPINAL TETHERING SYSTEM Back to Search Results
Catalog Number 8219500
Device Problem Break (1069)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 04/13/2020
Event Type  malfunction  
Manufacturer Narrative
Owi: bone fixation cerclage, sublaminar.Neither the device nor films of applicable imaging studies were returned to the manufacturer for evaluation.Therefore, we are unable to determine the definitive cause of the reported event.If information is provided in the future, a supplemental report will be issued.
 
Event Description
It was reported that the patient presented with scoliosis; and underwent a correction surgery at t6-l3.Intra-op, after placement was performed, the tethers broke while applying tension with the tensioner.Tension was applied when correction was once performed.After provisional fixation, loosening was performed.And when tension was applied again during the second correction, the tethers broke.Therefore, product from another manufacturer (nesplon) was used.The surgeon wondered whether correction was performed excessively.The broken product was removed with no fragment of the product remaining inside the patient.No patient complications were reported as a result of this event.
 
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Brand Name
TRANSLACE SPINAL TETHERING SYSTEM
Manufacturer (Section D)
MEDTRONIC SOFAMOR DANEK USA, INC
4340 swinea rd
memphis TN 38118
Manufacturer (Section G)
MEDTRONIC SOFAMOR DANEK USA, INC
4340 swinea rd
memphis TN 38118
Manufacturer Contact
stacie ziemba
1800 pyramid place
memphis, TN 38132
9013963133
MDR Report Key10052243
MDR Text Key190810139
Report Number1030489-2020-00521
Device Sequence Number1
Product Code OWI
UDI-Device Identifier00763000108397
UDI-Public00763000108397
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K163181
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Physician
Type of Report Initial
Report Date 05/13/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/13/2020
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number8219500
Device Lot NumberVS17C001
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received04/13/2020
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage N
Patient Sequence Number1
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