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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER SPINE-US XIA 3 TITANIUM ROD DIAM 6MM TI ALLOY L 480MM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM

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STRYKER SPINE-US XIA 3 TITANIUM ROD DIAM 6MM TI ALLOY L 480MM; THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM Back to Search Results
Catalog Number 48233480
Device Problems Device Dislodged or Dislocated (2923); Migration (4003)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
Event Date 11/09/2018
Event Type  malfunction  
Manufacturer Narrative
Product still remained implatned in the patient.
 
Event Description
It was reported that the two rods have dislodged post-op.The products still implanted in the patient.No other adverse consequence to the patient was reported.
 
Manufacturer Narrative
Method: x-ray image review, nc/capa history review, labelling review, risk assessment result : the reported event was confirmed via x rays.The device is still implanted in the patient therefore, device evaluation could not be performed.Lot # has not been provided , therefore, product history review could not be performed.X rays provided show the rods slipped out of the closed head screws.It was reported that patient was obese and anti torque not used.Post-op activity of the patient is unknown.Conclusion: as stated in the device ifu, the patient obesity, patient post op activity, and length of implantation could have contributed to the event.The extra weight on the implants could cause loosening over time.Additionally, not using anti torque when tightening down the blocker could have contributed as it could result in too much torque being applied to the set screw, possibly deforming it and reducing the surface area contacting the rod holding it in place.However, as the devices are still implanted, a definite root cause cannot be confirmed without evaluating the devices.Device is still implanted.
 
Event Description
It was reported that the two rods have dislodged post-op.The products still implanted in the patient.No other adverse consequence to the patient was reported.
 
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Brand Name
XIA 3 TITANIUM ROD DIAM 6MM TI ALLOY L 480MM
Type of Device
THORACOLUMBOSACRAL PEDICLE SCREW SYSTEM
Manufacturer (Section D)
STRYKER SPINE-US
2 pearl court
allendale NJ 07401
MDR Report Key8114496
MDR Text Key128747535
Report Number0009617544-2018-00283
Device Sequence Number1
Product Code NKB
UDI-Device Identifier07613154918454
UDI-Public07613154918454
Combination Product (y/n)N
PMA/PMN Number
K113666
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional
Type of Report Initial,Followup
Report Date 03/21/2019
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
Device Operator Health Professional
Device Catalogue Number48233480
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 11/09/2018
Initial Date FDA Received11/29/2018
Supplement Dates Manufacturer Received03/06/2019
Supplement Dates FDA Received03/21/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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