The complaint event could be confirmed based on the ct scans provided to design the new peek implant.The complaint department has already covered three previous reported events with medpor customized products lot# 2007161015 and lot#: 2011091030 with this patient under pi#: (b)(6).According to the previous investigations the patient had back-to-back issues with brain swelling.The surgeon used an external ventricular drain (evd) to drain extra cerebrospinal fluid (csf) from the brain.After loosening of the implant (lot#: 2011091030) in a previous reported event covered under pi#: (b)(6).The same complications occurred in the area where the swelling is present laterally and posteriorly to the patient¿s left eye.After this happened the surgeon decided to design a new implant again and switch to a customized peek implant from stryker (lot#: 2109161009).With the scans provided to design the peek implant, it could be confirmed that even though the implant was fixated appropriately, with more screws and plates than recommended, the implant loosened due to the pressure of the brain fluid in the area where the swelling of the patient is present.Furthermore, a review of the manufacturing records for medpor customized cranial-l (54440310), lot: 2011091030 was conducted.Final release test data confirmed the lot meets all final release specifications.Summarizing all obtained information, the root cause of the reported event that the fixation is pulling out from patient¿s bone was caused by the swelling present laterally and posteriorly to the patient¿s left eye prior to the implant.Additionally, it is the surgeon¿s responsibility to reduce the swelling prior to implanting the device.Based on the information provided, the statistical evaluation, the device history review and the complaint analysis by stryker¿s customized implants designer there is no indication for any systematic, material or manufacturing related issue.H3 other text: device not made available by customer.
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