FDA Adverse Event Injury Summary report: N

4.5MM LOCKING CONDYLAR PLATE

MDR report key: 1011889 · Received March 11, 2008

Report

Report Number
2520274-2008-00016
Event Type
Injury
Date Received
March 11, 2008
Report Date
February 14, 2008
Manufacturer
SYNTHES (USA)
Product Code
HRS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO HAS BEEN REQUESTED. SYNTHES IS UNABLE TO DETERMINE THE MFR SITE OR THE MFR DATE WITHOUT A LOT #. NO INVESTIGATION COULD BE PERFORMED, NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED.

Description of Event or Problem · 1

A 4.5MM LOCKING CONDYLAR PLATE, IMPLANTED ON AN UNK DATE, BROKE POST-OPERATIVE. PT WAS DIAGNOSED WITH NONUNION. DURING A REVISION PROCEDURE, THE BROKEN HARDWARE WAS REMOVED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 4.5MM LOCKING CONDYLAR PLATE LOCKING CONDYLAR PLATES HRS SYNTHES (USA) NA NI

Patients

Seq Age Sex Outcome Treatment
1 NI Required Intervention SCREWS