Catalog Number 48551000 |
Device Problems
Unintended Movement (3026); Migration (4003)
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Patient Problem
Injury (2348)
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Event Date 04/24/2019 |
Event Type
Injury
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Event Description
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A revision surgery was performed to replace the blocker which migrated post-operatively.The surgeon noted during the revision surgery that the rod had shifted; therefore, the rod, c3 and c4 screw were replaced, as well as the c3 and c4 blockers.
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Manufacturer Narrative
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Visual analysis found the blocker had appropriate contact marks from being tightened down onto the rod inside the polyaxial screws.Complaint history records were reviewed for the lot number provided and no similar events were identified.Manufacturing history records were reviewed for the lot number provided and no relevant manufacturing issues were identified.It was confirmed that the blocker had backed out via photo images provided.It was reported that the patient has myelopathy, fusion was not achieved, patient did not experience a fall and there were no complications during the surgery.The blockers were tightened to 3nm.The surgical technique states: "for patients with degenerative disease, the progression of degenerative disease may be so advanced at the time of implantation that it may substantially decrease the expected useful life of the appliance.In such cases, orthopaedic devices may be considered only as a delaying technique or to provide temporary relief." the plausible root cause of the reported event is patient disease.
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Event Description
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A revision surgery was performed to replace the blocker which migrated post-operatively.The surgeon noted during the revision surgery that the rod had shifted; therefore, the rod, c3 and c4 screw were replaced, as well as the c3 and c4 blockers.
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Search Alerts/Recalls
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