MAUDE Adverse Event Report: CENTINEL SPINE, LLC PRODISC C VIVO US IMPLANT MEDIUM 5MM; PROSTHESIS, INTERVERTEBRAL DISC

Model Number	PDVM5
Medical Device Problem Code	Migration (4003)
Health Effect - Clinical Code	Limb Pain (4836)
Date of Event	11/11/2024
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
An mdr is indicated for this complaint.It was reported that a patient (45yo, female) was implanted with a vivo implant at c5-6 on (b)(6) 2024.Patient had ongoing pain and it was found that the implant had migrated anteriorly.Surgeon completed the removal on (b)(6) 2024 and fused the patient.A dhr review found no anomalies associated with the complaint.Complaint trending found that the rate of complaints is within the level defined in the risk documentation.A review of the risk documentation found that the harms associated with the complaint are identified and mitigated to a level where the clinical benefits outweigh the risks.The removed implant will be evaluated following exponent's approved prodisc c device evaluation protocol.The report will be issued under pdcv-0026.Additionally, imaging was provided that showed the implant tilting to one side and migrating.The implant was removed due to implant migration, a reason for the migration is unknown.The submission is 1 of 1 devices involved in this event.
Event or Problem Description
Patient (45yo, female) was implanted with a vivo implant at c5-6 on (b)(6) 2024.Patient had ongoing pain and it was found that the implant had migrated anteriorly.Surgeon completed the removal on (b)(6) 2024 and fused the patient.

• Brand Name: PRODISC C VIVO US IMPLANT MEDIUM 5MM
• Common Device Name: PROSTHESIS, INTERVERTEBRAL DISC
• Manufacturer (Section D): CENTINEL SPINE, LLC; 900 airport road, suite 3b; west chester PA 19380
• Manufacturer (Section G): FRUH VERPACKUNGSTECHNIK AG; allmendstrasse 47; fehraltorf, 8320 ; SZ 8320
• Manufacturer Contact: erin ward ; 900 airport road; suite 3b; west chester, PA 19380 ; 4848878894
• MDR Report Key: 20792930
• Report Number: 3007494564-2024-00090
• Device Sequence Number: 20806942
• Product Code: MJO
• UDI-Device Identifier: 00843193113672
• UDI-Public: (01)00843193113672(17)280930(10)2023-1118
• Combination Product (Y/N): N
• Initial Reporter State: PA
• Initial Reporter Country: US
• PMA/510(K) Number: P070001
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2024
• Device Explanted Year: 2024
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 06/16/2026

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Health Professional
• Device Model Number: PDVM5
• Device Catalogue Number: N/A
• Device Lot Number: 2023-1118
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 11/12/2024
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 11/08/2024
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 11/27/2024
• Supplement Report FDA Received Date: 06/16/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 10/09/2023
• 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 Number: 1
• Outcome Attributed to Adverse Event: Required Intervention
• Patient Age: 45 YR
• Patient Sex: Female