FDA Adverse Event Injury Summary report: N

LCP 3.5 6HO L85 SST

MDR report key: 13591196 · Received February 24, 2022

Report

Report Number
2939274-2022-00648
Event Type
Injury
Date Received
February 24, 2022
Date of Event
January 1, 2022
Manufacturer
WRIGHTS LANE SYNTHES USA PRODUCTS LLC
Product Code
HRS
UDI-DI
10886982157911
PMA / PMN Number
K082807
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL NARRATIVE: ONLY EVENT YEAR IS KNOWN. ADDITIONAL DEVICE PRODUCT CODES: KTT AND HWC. COMPLAINANT PART IS NOT EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. THIS COMPLAINT WILL BE ACCOUNTED FOR AND MONITORED VIA POST MARKET SURVEILLANCE ACTIVITIES. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 0

ADDITIONAL NARRATIVE: ONLY EVENT YEAR IS KNOWN. ADDITIONAL DEVICE PRODUCT CODES: KTT AND HWC. COMPLAINANT PART IS NOT EXPECTED TO BE RETURNED FOR MANUFACTURER REVIEW/INVESTIGATION. WITHOUT A LOT NUMBER THE DEVICE HISTORY RECORDS REVIEW COULD NOT BE COMPLETED. PRODUCT WAS NOT RETURNED. BASED ON THE INFORMATION AVAILABLE, IT HAS BEEN DETERMINED THAT NO CORRECTIVE AND/OR PREVENTATIVE ACTION IS PROPOSED. THIS COMPLAINT WILL BE ACCOUNTED FOR AND MONITORED VIA POST MARKET SURVEILLANCE ACTIVITIES. IF ADDITIONAL INFORMATION IS MADE AVAILABLE, THE INVESTIGATION WILL BE UPDATED AS APPLICABLE. DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 0

IT WAS REPORTED THAT ON (B)(6) 2022, THE PATIENT UNDERWENT A REVISION OF A BOTH BONE FOREARM FRACTURE. TWO (2) 6 HOLE 3.5 LCP PLATES, EIGHT (8) 14MM 3.5 CORTEX SCREWS, AND FOUR (4) 12MM 3.5 CORTEX SCREWS WERE REMOVED. THE FRACTURE WAS REDUCED AND NEW IMPLANTS WERE PLACED. PROCEDURE AND PATIENT OUTCOME WERE UNKNOWN. THIS REPORT INVOLVES ONE (1) 3.5MM LCP PLATE 6 HOLES 85MM. THIS IS REPORT 13 OF 14 FOR (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT ON (B)(6) 2022, THE PATIENT UNDERWENT A REVISION OF A BOTH BONE FOREARM FRACTURE. TWO (2) 6 HOLE 3.5 LCP PLATES, EIGHT (8) 14MM 3.5 CORTEX SCREWS, AND FOUR (4) 12MM 3.5 CORTEX SCREWS WERE REMOVED. THE FRACTURE WAS REDUCED AND NEW IMPLANTS WERE PLACED. PROCEDURE AND PATIENT OUTCOME WERE UNKNOWN. THIS REPORT INVOLVES ONE (1) 3.5MM LCP PLATE 6 HOLES 85MM. THIS IS REPORT 13 OF 14 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
108189 LCP 3.5 6HO L85 SST PLATE, FIXATION, BONE HRS WRIGHTS LANE SYNTHES USA PRODUCTS LLC 223.561 10886982157911

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention 3.5MM CORTEX SCREW SELF-TAPPING 12MM| 3.5MM CORTEX SCREW SELF-TAPPING 12MM| 3.5MM CORTEX SCREW SELF-TAPPING 12MM| 3.5MM CORTEX SCREW SELF-TAPPING 12MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| 3.5MM CORTEX SCREW SELF-TAPPING 14MM| LCP 3.5 6HO L85 SST