FDA Adverse Event Other Summary report: N

BILOK SCREW

MDR report key: 1321124 · Received February 23, 2009

Report

Report Number
9617083-2009-00003
Event Type
Other
Date Received
February 23, 2009
Date of Event
December 30, 2008
Report Date
February 13, 2009
Manufacturer
BIOCOMPOSITES LTD.
Product Code
HWC
PMA / PMN Number
K003641
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

TRAUMATIC SPORTING INJURY LED TO FAILED ACL GRAFT RECONSTRUCTION AND REMOVAL OF GRAFT AND FIXATION SCREWS. A SEPARATE MDR IS FILED FOR THE BILOK SCREW USED IN THE SAME PROCEDURE.

Description of Event or Problem · 1

PT HAD ACL RECONSTRUCTION (B)(6)2007. PT HAD TRAUMATIC INJURY WHILE PLAYING SOCCER ON (B)(6)2008. ACL SCREW EXPLANTED (B)(6)2008.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BILOK SCREW ACL SCREW HWC BIOCOMPOSITES LTD. BILOK ST SCREW 10/05-PT410

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention