FDA Adverse Event Summary report: N

PATELLA CLAMP

MDR report key: 1170364 · Received September 8, 2008

Report

Report Number
1170364
Date Received
September 8, 2008
Date of Event
September 4, 2008
Report Date
September 8, 2008
Manufacturer
DEPUY ORTHOPEDICS INC.
Product Code
LXH
Report Source
User Facility report
Reporter Location
RI, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

PATELLA CLAMP PIN FELL OUT DURING PROCEDURE. IT WAS FOUND ON THE DRAPE. ALL PIECES OF THE PATELLA CLAMP WERE FOUND AND REMOVED FROM THE FIELD. NO HARM TO PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PATELLA CLAMP CLAMP, ORTHOPEDIC LXH DEPUY ORTHOPEDICS INC. PATELLA TRY 03 NOT KNOWN

Patients

Seq Age Sex Outcome Treatment
1 59 YR