FDA Adverse Event Injury Summary report: N

SUPRACONDYLAR NAIL ?11X240MM

MDR report key: 1284834 · Received January 9, 2009

Report

Report Number
9610622-2009-00003
Event Type
Injury
Date Received
January 9, 2009
Date of Event
December 1, 2008
Report Date
December 8, 2008
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
JDS
PMA / PMN Number
K023267
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFO HAS BEEN REQUESTED AND IF RECEIVED WILL BE SUBMITTED ON A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

THE PT UNDERWENT SURGERY WITH AO LOCKING PLATE. AFTER SURGERY, THE SURGEON FOUND THROUGH X-RAY THAT THE LOCKING PLATE BROKE. IN 2008, REVISION SURGERY WAS PERFORMED USING T2 SCN. HOWEVER, FOUR MONTHS LATER, THE SURGEON FOUND THROUGH THE X-RAY THAT THE T2 SCN BROKE. THE NAIL WAS BROKEN IN THE FORTH SCREW HOLE FROM DISTAL. EIGHT DAYS LATER, THE SURGEON PERFORMED THE REVISION SURGERY USING THE AO DFN, THE BONE GRAFT AND BONE APATITE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SUPRACONDYLAR NAIL ?11X240MM IMPLANT JDS STRYKER OSTEOSYNTHESIS KIEL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 69 YR Required Intervention