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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZIMMER SPINE SEQUOIA CLOSURE TOP

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ZIMMER SPINE SEQUOIA CLOSURE TOP Back to Search Results
Model Number N/A
Device Problem Insufficient Information (3190)
Patient Problem Pain (1994)
Event Date 03/18/2016
Event Type  Injury  
Manufacturer Narrative
Without a product return, no product evaluation is able to be conducted. Current information is insufficient to permit a valid conclusion about the cause of this event. If additional information is obtained that adds value to the relevant content of this report and/or a conclusion can be drawn, a follow-up report will be sent. Report four of four for the same event; see also 0002184052-2016-00032, 00033 and 00034.
 
Event Description
The facility reported that the screw, rod and connector from lt l4 fusion were removed from patient due to pain. Procedure was a lumbar fusion.
 
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Brand NameSEQUOIA CLOSURE TOP
Type of DeviceCLOSURE TOP
Manufacturer (Section D)
ZIMMER SPINE
7375 bush lake road
minneapolis MN 55439
Manufacturer (Section G)
ZIMMER SPINE
7375 bush lake road
minneapolis MN 55439
Manufacturer Contact
michelle cole
7375 bush lake road
minneapolis, MN 55439
MDR Report Key5609488
MDR Text Key43694397
Report Number0002184052-2016-00035
Device Sequence Number1
Product Code NKB
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
PK131980
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type distributor,health profession
Reporter Occupation
Type of Report Initial
Report Date 03/29/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/26/2016
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator
Device Model NumberN/A
Device Catalogue Number3301-1
Device Lot NumberUNKNOWN
Other Device ID NumberN/A
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received03/29/2016
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unkown
Removal/Correction NumberN/A

Patient Treatment Data
Date Received: 04/26/2016 Patient Sequence Number: 1
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