FDA Adverse Event Injury Summary report: N

TOGGLELOC ELBOW IMPLANT SYSTEM

MDR report key: 1903931 · Received November 20, 2010

Report

Report Number
1825034-2010-00603
Event Type
Injury
Date Received
November 20, 2010
Date of Event
October 18, 2010
Report Date
October 21, 2010
Manufacturer
BIOMET SPORTS MEDICINE, INC.
Product Code
MBI
PMA / PMN Number
K083070
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A CONCLUSION AS TO THE CAUSE OF THE EVENT. REVIEW OF DEVICE HISTORY RECORDS SHOW THAT LOT RELEASED WITH NO RECORDED ANOMALY OR DEVIATION. THE USER FACILITY WAS NOTIFIED OF THE EVENT ON (B)(6) 2010. TO DATE, A RESPONSE HAS NOT BEEN RECEIVED FROM THE USER FACILITY. IN THE EVENT THAT THE USER FACILITY SUBMITS A MEDWATCH REPORT, BIOMET WILL FORWARD A COPY TO THE FDA. THIS REPORT SUBMITTED (B)(6) 2010.

Description of Event or Problem · 1

IT WAS REPORTED THAT PATIENT UNDERWENT ELBOW PROCEDURE ON (B)(6) 2010. AS THE SURGEON WENT TO TIGHTEN THE TOGGLELOC, IT BECAME STUCK, AND WOULD NOT ADVANCE. SURGEON REMOVED THE TOGGLELOC AND USED FIBER WIRE TO COMPLETE THE PROCEDURE, BUT ONLY AFTER A DELAY OF MORE THAN HALF AN HOUR HAD OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TOGGLELOC ELBOW IMPLANT SYSTEM FASTENER, FIXATION MBI BIOMET SPORTS MEDICINE, INC. N/A 228020

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R