FDA Adverse Event Injury Summary report: N

NI

MDR report key: 1780994 · Received July 28, 2010

Report

Report Number
2520274-2010-00148
Event Type
Injury
Date Received
July 28, 2010
Report Date
June 28, 2010
Manufacturer
SYNTHES (USA)
Product Code
KTT
PMA / PMN Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO HAS BEEN REQUESTED. SYNTHES IS UNABLE TO DETERMINE MANUFACTURING SITE OR MANUFACTURING DATE WITHOUT A LOT NUMBER. SYNTHES IS UNABLE TO DETERMINE 510(K) # WITHOUT A PART OR LOT NUMBER. INVESTIGATION IS ON GOING; NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED OR LOT NUMBER PROVIDED. PT WILL RETAIN HARDWARE. DEVICE WILL NOT BE RETURNED TO SYNTHES FOR INVESTIGATION.

Description of Event or Problem · 1

PT IMPLANTED WITH LCP CONDYLAR PLATE, SCREW AND CABLES FOR A COMMINUTED MIDSHAFT RIGHT FEMUR FRACTURE. PT EXPERIENCED POSTOP BREAKAGE OF THE PLATE, A BROKEN SCREW HEAD AND TWO LOOSE CABLES. HARDWARE WAS REMOVED. PT WAS REVISED TO A LARGER PLATE, ALONG WITH SCREWS, CABLES AND POSSIBLE ALLOGRAFT STRUT. THIS IS THE 4TH OF 4 REPORTS SUBMITTED ON THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NI CABLE KTT SYNTHES (USA) NA NI

Patients

Seq Age Sex Outcome Treatment
1 84 YR Required Intervention PLATE| SCREWS| CABLES