FDA Adverse Event Injury Summary report: N

2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE.

MDR report key: 1924823 · Received December 8, 2010

Report

Report Number
3003506883-2010-00066
Event Type
Injury
Date Received
December 8, 2010
Report Date
November 11, 2010
Manufacturer
SYNTHES ELMIRA
Product Code
HRS
PMA / PMN Number
K083213
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION HAS BEEN REQUESTED. INVESTIGATION IS ON-GOING. REVIEW OF MANUFACTURING RECORDS HAS BEEN REQUESTED.

Description of Event or Problem · 1

PATIENT WAS IMPLANTED WITH 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE AND PLACED IN A WALKING CAST. AFTER THE WALKING CAST WAS REMOVED, PATIENT APPARENTLY ROLLED HER ANKLE AND THE PLATE BROKE. THE PLATE WAS REMOVED AND REPLACED WITH A 3.5MM LCP 8 HOLE PLATE AND SCREWS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 2.7MM/3.5MM LCP LATERAL DISTAL FIBULA PLATE. LCP LATERAL DISTAL FIBULA PLATE HRS SYNTHES ELMIRA NA 6360525

Patients

Seq Age Sex Outcome Treatment
1 52 YR Required Intervention SCREWS