FDA Adverse Event Injury Summary report: N

FW,BPB #2 SUTR,BLU W/NDL

MDR report key: 19533131 · Received June 13, 2024

Report

Report Number
1220246-2024-05727
Event Type
Injury
Date Received
June 13, 2024
Date of Event
January 6, 2023
Report Date
June 13, 2024
Manufacturer
ARTHREX, INC.
Product Code
GAT
UDI-DI
00888867041264
PMA / PMN Number
K122374
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

BASED ON THE INFORMATION PROVIDED WHICH MAY INCLUDE THE DEVICE (IF AVAILABLE AND RETURNED), PICTURES, VIDEOS, EVENT DESCRIPTION, AND ANY ADDITIONAL INFORMATION FROM THE FIELD, ARTHREX WAS ABLE TO CONCLUDE A MOST LIKELY CAUSE. THE MOST LIKELY CAUSE FOR THE REPORTED FAILURE CAN BE ATTRIBUTED TO A PATIENT-SPECIFIC EVENT.

Description of Event or Problem · 0

ON 1/18/2023, IT WAS REPORTED BY AN ARTHREX EMPLOYEE VIA EMAIL THAT AN AR-1400TB BIO-INTERFERENCE SCREW FULL THREAD, AN AR-1588T ACL TIGHTROPE, (3) AR-2324BCC-2 BIO COMPOSITE SWIVELOCK, (3) AR-4500 MENISCAL CINCH, (4) AR-7200 FIBERWIRE, AND (2) AR-7237 FIBERTAPE WERE ALL IMPLANTED IN THE PATIENT. THIS ACL AND LIGAMENT PROCEDURE TOOK PLACE ON (B)(6) 2023. PATIENT DEVELOPED AN INFECTION POST OPERATIVE, AND PATIENT REMAINS ADMITTED TO THE HOSPITAL FOR TREATMENT. NO FURTHER INFORMATION HAS BEEN PROVIDED AT THIS TIME. ADDITIONAL INFORMATION RECEIVED ON 5/15/2024: THE PATIENT HAS NOT UNDERGONE REVISION SURGERY, AND NO FURTHER INFORMATION HAS BEEN RECEIVED REGARDING THIS INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
955591 FW,BPB #2 SUTR,BLU W/NDL POLYETHYLENE SYNTHETIC SUTURE GAT ARTHREX, INC. FW,BPB #2 SUTR,BLU W/NDL 24720 00888867041264

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other