FDA Adverse Event Injury Summary report: N

PEDILOC 3.5MM CONTOUR LOCKING COMPRESSION FEMUR PLATE

MDR report key: 10267696 · Received July 13, 2020

Report

Report Number
3006460162-2020-00079
Event Type
Injury
Date Received
July 13, 2020
Date of Event
June 3, 2020
Report Date
June 16, 2020
Manufacturer
ORTHOPEDIATRICS, CORP
Product Code
HRS
PMA / PMN Number
K140431
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS INDICATED THAT THE PRODUCT IS IN PROCESS OF BEING RETURNED TO ORTHOPEDIATRICS FOR INVESTIGATION. ONCE THE INVESTIGATION HAS BEEN COMPLETED, A FOLLOW-UP MDR WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DISTAL LOCKING SCREW SEEMED TO HAVE BACKED OUT OF THE RIGHT 3.5MM 8-HOLE DISTAL FEMUR PLATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
731769 PEDILOC 3.5MM CONTOUR LOCKING COMPRESSION FEMUR PLATE PEDILOC HRS ORTHOPEDIATRICS, CORP 00-1065-3008 192730-C

Patients

Seq Age Sex Outcome Treatment
1 4 YR