FDA Adverse Event Other Summary report: N

STANDARD KOMPRESSOR SCREW 20 MM

MDR report key: 1981374 · Received February 3, 2011

Report

Report Number
3004608878-2011-00011
Event Type
Other
Date Received
February 3, 2011
Date of Event
December 27, 2010
Report Date
February 3, 2011
Manufacturer
INTEGRA LIFESCIENCES CORP. (INTEGRA-OHIO)
Product Code
HBL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFO.

Description of Event or Problem · 1

THE REPORTER STATED THAT DURING A BUNION SURGERY PROCEDURE, THE PT'S BONE WAS CRACKED WHILE THE SURGEON WAS ADVANCING THE TRAILING HEAD OF THE SCREW. STAPLES WERE USED AS A TEMPORARY FIXATION. THE PT REPORTED MORE POSTOPERATIVE PAIN THAN IS USUAL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STANDARD KOMPRESSOR SCREW 20 MM KOMPRESSOR COMPRESSION SCREW SYSTEM HBL INTEGRA LIFESCIENCES CORP. (INTEGRA-OHIO) 8340208714J9

Patients

Seq Age Sex Outcome Treatment
1 50 YR Required Intervention