FDA Adverse Event Injury Summary report: N

UNKN SUSPENSORY FIXATION DEV

MDR report key: 11556315 · Received March 23, 2021

Report

Report Number
1219602-2021-00609
Event Type
Injury
Date Received
March 23, 2021
Date of Event
February 28, 2021
Report Date
April 21, 2021
Manufacturer
SMITH & NEPHEW, INC.
Product Code
MBI
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

THE REPORTED DEVICE, USED IN TREATMENT, WAS NOT RETURNED TO THE DESIGNATED COMPLAINT UNIT FOR INDEPENDENT EVALUATION, THUS VISUAL INSPECTION AND FUNCTIONAL TESTING COULD NOT BE PERFORMED. THE INSTRUCTIONS FOR USE WAS REVIEWED AND FOUND TO INCLUDE CONDITIONS OF OFF LABEL USE AND TECHNIQUE SPECIFICS, AS WELL AS PRECAUTIONS AND WARNINGS RELATED TO THE USE OF THE DEVICE. A REVIEW OF RISK MANAGEMENT FILES FOUND THAT THE REPORTED FAILURE WAS DOCUMENTED APPROPRIATELY. A COMPLAINT HISTORY REVIEW CONCLUDED THIS WAS AN ISOLATED EVENT. ATTEMPTS TO OBTAIN MEDICAL DOCUMENTS WERE UNSUCCESSFUL AND THUS A THOROUGH MEDICAL INVESTIGATION WAS NOT PERFORMED. A RELATIONSHIP, IF ANY, BETWEEN THE SUBJECT DEVICE AND THE REPORTED EVENT COULD NOT BE DETERMINED. PLEASE REFER TO THE INSTRUCTIONS FOR USE FOR RECOMMENDATIONS ON PROPER USE OF THE DEVICE AND POTENTIAL TROUBLESHOOTING METHODS TO PREVENT FUTURE REOCCURRENCE OF THE REPORTED EVENT. IF THE PRODUCT ASSOCIATED WITH THIS EVENT IS RETURNED AT A FUTURE DATE, THIS INVESTIGATION WILL BE REOPENED FOR EVALUATION.

Additional Manufacturer Narrative · 1

INTERNAL COMPLAINT REFERENCE (B)(4). LITERATURE: THE RELATED RESEARCH OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH AUTOLIGOUS PERONEUS LOUGUS TENDON OR HAMSTING TENDON.

Description of Event or Problem · 1

IT WAS REPORTED THAT ON LITERATURE REVIEW, "THE RELATED RESEARCH OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH AUTOLIGOUS PERONEUS LONGUS TENDON OR HAMSTRING TENDON", 2 PATIENTS EXPERIENCED REJECTION OF THE INTERNAL FIXATION, THEY DEVELOPED FEVER AND HAD A LITTLE EXUDATE AT THE LOWER ENTRANCE OF THE BONE CANAL AFTER SURGERY WITH AN ENDOBUTTON. THE COMPLICATIONS WERE TREATED SYMPTOMATICALLY AND THE SYMPTOMS DISAPPEARED AFTER 1 WEEK. NO FURTHER INFORMATION IS AVAILABLE. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED ACCORDINGLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
448384 UNKN SUSPENSORY FIXATION DEV FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE MBI SMITH & NEPHEW, INC. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other| R