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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: WARSAW ORTHOPEDICS CATALYFT¿ PL EXPANDABLE INTERBODY SYSTEM; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT,

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WARSAW ORTHOPEDICS CATALYFT¿ PL EXPANDABLE INTERBODY SYSTEM; INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT, Back to Search Results
Model Number 6068096
Medical Device Problem Codes Mechanics Altered (2984); Migration (4003)
Health Effect - Clinical Code Numbness (2415)
Date of Event 06/01/2022
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
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.Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
Event or Problem Description
Information received from healthcare provider via manufacturer representative regarding an event happened during post-op of the repo rted product.The pre-op diagnosis was mentioned as lumbar spinal stenosis.It was reported that, a cage was inserted on (b)(6).Pl long was used and placed one piece on one side.Because it makes a squeaky-like noise for about 3 to 4 turns, then the opening is stopped.It was confirmed from the image that the cage was firmly opened and adhered to the end of the vertebral body.After that, another company's screw was inserted and compression was applied to close the incision.At post one month after surgery, there was no problem, but after that, it was confirmed with the image diagnosis that the cage was gradually shrinking.It is claimed that every two weeks it is photographed, and gradually it is closing.The cage is currently being backed out, the reported another company's screw did not caused/contributed for failure of cage.The current symptoms are calm and there are no plans for revision surgery.The patient numbness was likely related to cage back out.The procedure or technique performed was mistlif of l4/5 and the levels implanted were l4/l5.Patient had a symptom of numbness.No further complications reported.
 
Additional Manufacturer Narrative
Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
Event or Problem Description
Additional information received from manufacturer representative stating the subsidence in the cage was observed, and the area about 1/3(one third) after the cage was protruding from the posterior edge of the vertebral body, but the neurological symptoms is alleviated and the patient is currently under observation.As such, the currently revision is not scheduled.No further complications reported.
 
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Brand Name
CATALYFT¿ PL EXPANDABLE INTERBODY SYSTEM
Common Device Name
INTERVERTEBRAL FUSION DEVICE WITH BONE GRAFT,
Manufacturer (Section D)
WARSAW ORTHOPEDICS
2500 silveus crossing
warsaw IN 46582
Manufacturer (Section G)
WARSAW ORTHOPEDICS
2500 silveus crossing
warsaw IN 46582
Manufacturer Contact
glen belmer
1800 pyramid place
memphis, TN 38132
6122713209
MDR Report Key15263900
Report Number1030489-2022-00789
Device Sequence Number17610209
Product Code MAX
UDI-Device Identifier00763000246730
UDI-Public00763000246730
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K210425
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2022
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 10/06/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number6068096
Device Catalogue Number6068096
Device Lot Number0864036W
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/29/2022
Supplement Date Received by Manufacturer09/14/2022
Initial Report FDA Received Date08/22/2022
Supplement Report FDA Received Date10/06/2022
Date Device Manufactured10/06/2021
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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