FDA Adverse Event Injury Summary report: N

MILAGRO BIORECPLACEABLE INTERFERENCE SCREW

MDR report key: 1132643 · Received August 22, 2008

Report

Report Number
1221934-2008-00418
Event Type
Injury
Date Received
August 22, 2008
Date of Event
August 15, 2008
Report Date
August 22, 2008
Manufacturer
DEPUY MITEK
Product Code
MBI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

FOLLOW-UP CONTACT WITH SURGEON INDICATED REVISION SURGERY TO REMOVE THE DEVICES WAS PERFORMED IN 2008. TO DATE THAT IS ALL THE INFORMATION WE RECEIVED. IT HAS BEEN REPORTED THE DEVICES WILL BE RETURNED, BUT AT THIS POINT, IT DOES NOT APPEAR THEY WILL BE RETURNED WITHIN 30 DAYS AS REQUIRED BY THE REGULATION. DEPUY MITEK IS IN THE PROCESSING OF GATHERING MORE INFORMATION ABOUT THE EVENT AND WILL FILE A FOLLOW-UP REPORT WHEN THE DEVICE IS RETURNED FOR EVALUATION.

Description of Event or Problem · 1

A DEPUY MITEK MARKETING EMPLOYEE IS REPORTING A SURGEON TOLD HIM A PATIENT WHO HAD AN ACL PROCEDURE RETURNED WITH SWELLING AND PAIN 7 MONTHS POST-OP. A MILAGRO INTERFERENCE SCREW WAS USED ON THE TIBIAL SIDE. A RIGIDFIX CROSSPIN WAS ALSO USED IN THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MILAGRO BIORECPLACEABLE INTERFERENCE SCREW SOFT TISSUE FIXATION DEVICE MBI DEPUY MITEK UNK

Patients

Seq Age Sex Outcome Treatment
1