FDA Adverse Event Injury Summary report: N

4.5MM LCP PROXIMAL FEMUR

MDR report key: 1163098 · Received September 16, 2008

Report

Report Number
2520274-2008-00070
Event Type
Injury
Date Received
September 16, 2008
Date of Event
August 7, 2008
Report Date
August 20, 2008
Manufacturer
SYNTHES (USA)
Product Code
HRS
PMA / PMN Number
K030858
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS INFO WAS NOT PROVIDED DURING THE INITIAL REPORT. ADD'L INFO HAS BEEN REQUESTED. SYNTHES IS UNABLE TO DETERMINE THE MFR OR THE MFR DATE WITHOUT A LOT NUMBER. NO INVESTIGATION COULD BE PERFORMED, NO CONCLUSION DRAWN, AS NO DEVICE WAS RETURNED.

Description of Event or Problem · 1

PT COMPLAINED OF PAIN THREE MOS AFTER AN IMPLANTATION OF A LCP PLATE. A POST-OP X-RAY SHOWED A NON-UNION AND A BROKEN PLATE. SURGEON REVISED THE SHORTER PROXIMAL FEMORAL PLATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 4.5MM LCP PROXIMAL FEMUR PROXIMAL FEMUR PLATE HRS SYNTHES (USA) NA NI

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention LOCKING SCREWS