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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: LDR MÉDICAL CLOSED CERVICAL CAGE 14X15.5 H6MM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM

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LDR MÉDICAL CLOSED CERVICAL CAGE 14X15.5 H6MM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM Back to Search Results
Catalog Number MC322P
Device Problem Biocompatibility (2886)
Patient Problems Inflammation (1932); Pain (1994)
Event Type  Injury  
Manufacturer Narrative
Without a product return, no product evaluation is able to be conducted.Current information is insufficient to permit a valid conclusion about the cause of this event.If additional information is obtained that adds value to the relevant content of this report and/or a conclusion can be drawn, a follow-up report will be sent.Reference reports 3004788213-2023-00048 through 3004788213-2023-00051.
 
Event Description
A patient reported inflammation and chronic pain due to the metals or plastic components in two mc+ cages and plates.The constructs remain implanted.This is report three of four for this event.
 
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Brand Name
CLOSED CERVICAL CAGE 14X15.5 H6MM
Type of Device
THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM
Manufacturer (Section D)
LDR MÉDICAL
quartier europe de l¿ouest
5, rue de berlin
sainte-savine, na 10300
FR  10300
Manufacturer (Section G)
LDR MÉDICAL
quartier europe de l¿ouest
5, rue de berlin
sainte-savine, na 10300
FR   10300
Manufacturer Contact
kim martinez
10225 westmoor dr.
na
westminster, CO 80021
3035144809
MDR Report Key16973584
MDR Text Key315662482
Report Number3004788213-2023-00050
Device Sequence Number1
Product Code NKB
UDI-Device Identifier03662663021432
UDI-Public(01)03662663021432(10)20574R253
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
K121103
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Consumer,Health Professional
Reporter Occupation Physician
Type of Report Initial
Report Date 05/22/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/22/2023
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberMC322P
Device Lot Number20574R253
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received04/27/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
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