• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SPINAL ELEMENTS, INC LOTUS; POSTERIOR CERVICAL SCREW SYSTEM

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

SPINAL ELEMENTS, INC LOTUS; POSTERIOR CERVICAL SCREW SYSTEM Back to Search Results
Catalog Number 32540-028
Device Problems Fracture (1260); Mechanical Problem (1384)
Patient Problem Failure of Implant (1924)
Event Date 03/19/2024
Event Type  malfunction  
Manufacturer Narrative
There is no plan for revision surgery and the devices remain in situ.The devices were not returned and are not available for evaluation.Image confirming the event was received depicting the fracture near the mid point of the screw.Lot numbers were not provided.Unknown factors include: patient activity at the time or prior to the event, patient bone quality, the degree of spinal instability, duration of implantation, the degree of pseudarthrosis, patient compliance with post-operative care instructions or if the patient sustained a fall/impact of any sort (no trauma was reported.) these factors dictate the longevity of the implant.Root cause or specific failure mode cannot be determined.
 
Event Description
Patient underwent pcf spinal fusion surgery at c2-t1 on (b)(6) 2023.On (b)(6) 2024 it was reported that both t1 bone screws were fractured.There is no plan to revise the patient.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
LOTUS
Type of Device
POSTERIOR CERVICAL SCREW SYSTEM
Manufacturer (Section D)
SPINAL ELEMENTS, INC
3115 melrose drive, suite 200
carlsbad CA 92010
Manufacturer (Section G)
SPINAL ELEMENTS
3115 melrose dr
carlsbad CA 92010
Manufacturer Contact
peter perhach
3115 melrose dr
carlsbad, CA 92010
MDR Report Key18980378
MDR Text Key338726902
Report Number3004893332-2024-00004
Device Sequence Number1
Product Code NKG
UDI-Device Identifier00840606106177
UDI-Public00840606106177
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K151705
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Distributor
Reporter Occupation Physician
Type of Report Initial
Report Date 03/26/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/26/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number32540-028
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/19/2024
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 Initial
Patient Sequence Number1
Patient Age72 YR
Patient SexMale
-
-