FDA Adverse Event Summary report: N

1.5X5MM HT SD X-DR SCR, EA

MDR report key: 1935176 · Received December 22, 2010

Report

Report Number
1032347-2010-00203
Date Received
December 22, 2010
Date of Event
November 29, 2010
Report Date
December 1, 2010
Manufacturer
BIOMET MICROFIXATION
Product Code
HWC
PMA / PMN Number
K953385
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE WARNINGS IN THE PACKAGE INSERT STATE THIS TYPE OF EVENT CAN OCCUR. CURRENT INFORMATION IS INSUFFICIENT TO PERMIT A VALID CONCLUSION ABOUT THE CAUSE OF THIS EVENT. IF ADDITIONAL INFORMATION IS OBTAINED THAT ADDS VALUE TO THE RELEVANT CONTENT OF THIS REPORT AND/OR A CONCLUSION CAN BE DRAWN, A FOLLOW-UP REPORT WILL BE SENT.

Description of Event or Problem · 1

IT WAS REPORTED WHEN THE DOCTOR WAS IMPLANTING SCREWS, THREE OF THEM BROKE AND THE TIPS OF THE SCREWS REMAIN IN THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 1.5X5MM HT SD X-DR SCR, EA BONE SCREW HWC BIOMET MICROFIXATION UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1