FDA Adverse Event Injury Summary report: N

SIGN I. M. NAIL

MDR report key: 1882295 · Received October 20, 2010

Report

Report Number
3034525-2010-00016
Event Type
Injury
Date Received
October 20, 2010
Date of Event
September 30, 2010
Report Date
September 30, 2010
Manufacturer
SURGICAL IMPLANT GENERATION NETWORK (SIGN)
Product Code
HSB
PMA / PMN Number
K022632
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AF
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

REVIEW OF THE X-RAY SHOWS THE CLEAR CAUSE WAS A SHIFT OF THE NON-UNION FRACTURE SITE WHICH PUT A HIGH AMOUNT OF STRESS ON THE DISTAL END OF THE NAIL AT FULL WEIGHT BEARING. SURGEON REPLACED THE NAIL. NO INDICATION OF PRODUCT DEFECT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SIGN I. M. NAIL STANDARD I. M. NAIL HSB SURGICAL IMPLANT GENERATION NETWORK (SIGN) 90380 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 15 YR Hospitalization