FDA Adverse Event
Malfunction
Summary report: N
INCORE LAPIDUS SINGLE USE
MDR report key: 10520908
·
Received September 11, 2020
Report
- Report Number
- 3009540749-2020-00029
- Event Type
- Malfunction
- Date Received
- September 11, 2020
- Date of Event
- August 12, 2020
- Report Date
- September 11, 2020
- Manufacturer
- NEXTREMITY SOLUTIONS
- Product Code
- HWC
- PMA / PMN Number
- K190231
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- 003
Narratives
Additional Manufacturer Narrative · 1
IF ADDITIONAL INFORMATION IS OBTAINED WHICH CHANGES THE OUTCOME OF THE INVESTIGATION, A FOLLOW-UP REPORT WILL BE FILED.
Description of Event or Problem · 1
IT WAS REPORTED A SURGERY OCCURRED WITH THE INCORE LAPIDUS SINGLE USE SYSTEM ON AN UNKNOWN DATE. AT AN UNKNOWN POST OP DATE, THE SURGEON NOTED THE SCREW MISSED THE POST. NO PATIENT COMPLICATIONS WERE REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 986252 | INCORE LAPIDUS SINGLE USE | SCREW | HWC | NEXTREMITY SOLUTIONS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |