VALKYRIE THORACIC FIXATION SYSTEM
Report
- Report Number
- 3014680795-2024-00009
- Event Type
- Injury
- Date Received
- July 19, 2024
- Date of Event
- May 1, 2023
- Report Date
- July 15, 2024
- Manufacturer
- J.M. LONGYEAR MANUFACTURING, LLC
- Product Code
- HRS
- PMA / PMN Number
- K232515
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IA, US
- Reporter Occupation
- PHYSICIAN
- Health Professional
- Yes
Narratives
UDI RELATED DATA QUALITY UPDATES ONLY CORRECT D4 AND H5 CONTENT TO MATCH GUDID.
THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR PART 803. THIS REPORT MAY BE BASED ON INFORMATION THAT HAS NOT BEEN ABLE TO BE COMPLETELY INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION THAT THE REPORT CONSTITUTES AND ADMISSION THAT THE DEVICE, THE COMPANY, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. AS OF THE DATE OF THIS REPORT, THE DEVICE HAS NOT BEEN EXPLANTED, PRODUCT IS UNAVAILABLE FOR EVALUATION. LOT NUMBER DETAILS ARE UNAVAILABLE. IMAGERY IS NOT AVAILABLE. A DEFINITIVE ROOT CAUSE CANNOT BE DETERMINED. IF ADDITIONAL INFORMATION RELEVANT TO THE INVESTIGATION OR OTHER CONTENT OF THIS REPORT IS IDENTIFIED, THIS REPORT WILL BE UPDATED. MULTIPLE MDR REPORTS WERE FILED FOR THIS EVENT, PLEASE SEE ASSOCIATED REPORTS: 3014680795-2024-00010; 3014680795-2024-00011; 3014680795-2024-00012; 3014680795-2024-00013; 3014680795-2024-00014.
IT WAS REPORTED THAT A PATIENT WHO UNDERWENT STERNAL CLOSURE USING A VARIETY OF PLATES AND SCREWS FOLLOWING A CORONARY ARTERY BYPASS GRAFT SURGERY IN (B)(6)2023 WAS OBSERVED WITH INSTABILITY IN THE LOWER PORTION OF THE STERNUM AT A SUBSEQUENT FOLLOW-UP APPOINTMENT MORE THAN A YEAR LATER. A STERNAL DEHISCENCE IS PRESENT WITH IMPLANTS DISLOCATED FROM THEIR INTENDED POSITION. NO FOLLOW-UP SURGERY IS PLANNED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1754753 | VALKYRIE THORACIC FIXATION SYSTEM | PLATE | HRS | J.M. LONGYEAR MANUFACTURING, LLC | 01-020 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Male | Other |