MAUDE Adverse Event Report: CENTINEL SPINE, LLC. PRODISC L INFERIOR END PLATE MEDIUM 3-STERILE; PROSTHESIS, INTERVERTEBRAL DISC

Model Number	PDL-M-IP03S
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Bone Fracture(s) (1870)
Date of Event	11/03/2025
Type of Reportable Event	Serious Injury
Event or Problem Description
A patient was implanted with two prodisc l devices at l4/5 and l5/s1 on (b)(6) 2025.After the implantation surgery, the patient was having nerve pain and it was found that the posterior aspect of the superior vertebral body broke off and dislodged at the l5/s1 level.On (b)(6) 2025 the surgeon removed the implant, replaced it with an anterior lumbar cage as well as completed posterior decompression and screw fixation at that level.
Additional Manufacturer Narrative
An mdr is indicated for this complaint.It was reported that a patient was implanted with two prodisc l devices at l4/5 and l5/s1 on (b)(6) 2025.After the implantation surgery, the patient was having nerve pain and it was found that the posterior aspect of the superior vertebral body broke off and dislodged at the l5/s1 level.On (b)(6) 2025 the surgeon removed the implant, replaced it with an anterior lumbar cage as well as completed posterior decompression and screw fixation at that level.A dhr review found no anomalies associated with this complaint.Complaint trending found that the rate of complaints is within the level outlined in the risk documentation.A review of the risk documentation found that the hazards associated with the complaint are identified and mitigated to a level where the clinical benefits outweigh the risks.The implant was not returned following removal surgery therefore no device evaluation could be completed.Pre-removal and post-removal imaging was provided.There were no anomalies identified during the complaint investigation.The removal was completed due to the vertebral body fracture.The submission is 3 of 3 devices involved in this event.

• Brand Name: PRODISC L INFERIOR END PLATE MEDIUM 3-STERILE
• 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: 23584539
• Report Number: 3007494564-2025-00128
• Device Sequence Number: 9505891
• Product Code: MJO
• UDI-Device Identifier: 00843193114969
• UDI-Public: (01)00843193114969(17)300630(10)2025-0197
• Combination Product (Y/N): N
• Initial Reporter State: PA
• Initial Reporter Country: US
• PMA/510(K) Number: P050010
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2025
• Device Explanted Year: 2025
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date (Section B): 11/18/2025

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: PDL-M-IP03S
• Device Catalogue Number: N/A
• Device Lot Number: 2025-0197
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 10/28/2025
• Initial Report FDA Received Date: 11/18/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 07/22/2025
• 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: 43 YR
• Patient Sex: Female