FDA Adverse Event Injury Summary report: N

UNKNOWN PRODUCT - SCREW

MDR report key: 2001685 · Received February 22, 2011

Report

Report Number
9610622-2011-00076
Event Type
Injury
Date Received
February 22, 2011
Date of Event
February 2, 2011
Report Date
February 4, 2011
Manufacturer
STRYKER OSTEOSYNTHESIS KIEL
Product Code
HWC
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SAME PT AS MDR 96140622-2011-00075.

Description of Event or Problem · 1

CUSTOMER REPORTED VIA SALES REP THAT THE PRODUCT WAS IMPLANTED INTO THE PT SUCCESSFULLY. PT WAS DISCHARGED. THE FIRST IMPLANT WAS DONE IN (B)(6) 2010. THE CUSTOMER FURTHER ADDED THAT ABOUT 6 MONTHS AFTER THE FIRST IMPLANT THE DISTAL LOCKING SCREW BROKE. THE NAIL BROKE WHICH LEAD TO THE PT HAVING REVISED SURGERY ON (B)(6) 2011.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN PRODUCT - SCREW IMPLANT HWC STRYKER OSTEOSYNTHESIS KIEL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention